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Loma335 TXTPDF 19 m1
Loma335 TXTPDF 19 m1
Insurance Professionals
Online Course
Module 1
Portal with
Course Enrollment.
See inside for details.
Operational Excellence for Insurance
Professionals
Project Managers: Jennifer W. Herrod, FLMI, PCS, AIAA, PAHM, ARA, AIRC
Gene Stone, FLMI, ACS, CLU
Workflow Coordinator: Shawn Cuthbert
ISBN978-1-57974-467-0
Operational Excellence for Insurance Professionals Preface | PREF.1
Preface
Operational Excellence for Insurance Professionals provides information about how an
insurance company operates and describes the different techniques and tools
companies use for decision-making. The text uses examples from fictional companies
to demonstrate various operational scenarios. This text is comprised of three
modules:
Module 1: People and Purpose (Chapters 1–3)
Module 2: Business Processes (Chapters 4–6)
Module 3: Decision Making (Chapters 7–10)
Acknowledgments
Operational Excellence for Insurance Professionals is the result of the combined efforts of
industry experts who served on a text development panel and LOMA staff and
consultants. The LOMA 335 authors wish to express gratitude for the dedication,
knowledge, expertise, and guidance provided by all of these individuals throughout
the development of this course.
members for all of their hard work. LOMA 335 is founded on the collaborative efforts
of a dedicated project team of LOMA staff members.
Finally, we extend a very special thank you to Jennifer W. Herrod, FLMI, PCS, AIAA,
PAHM, ARA, AIRC, AVP, Learning Content, who served as project manager and
provided guidance and support throughout the project; and Katherine C. Milligan,
FLMI, ACS, ALHC, Senior Vice President, Education and Training Division, who provided
leadership, guidance, resources, and support for this project.
Jo Ann S. Appleton, FLMI, ASRI, PCS, ALHC, HIA
Courtney Eiland, FLMI, ASRI, AIRC, ACS
Atlanta, Georgia
2019
Introduction
The purpose of LOMA 335 -- Operational Excellence for Insurance Professionals is to
present the business conditions and risks unique to the insurance industry and help
learners understand how to maximize value from company operations. Key topics
include aligning operations with corporate strategies, creating cultures of excellence,
managing business processes, and making decisions.
Enrollment in the course includes access to an online Course Portal, from which
learners access everything they need to study and prepare for the course
examination. The Course Portal organizes the assigned text material into convenient
Modules—chapter clusters that help to focus the learning process by breaking up the
course content into meaningful sections. In addition to the assigned study materials,
the Course Portal provides access to an array of blended learning resources, including
multimedia features designed to enhance the learning experience. The Course Portal
provides access to
Interactive e-book and PDF versions of the assigned text
An interactive version of the Test Preparation Guide’s Practice Questions and
Sample Exam with optional answer choice feedback
A library of animated videos to accompany the text
Recommended study plans to help you set goals and manage your learning
experience
Students enrolled in the version of the course that features self-proctored
modularized exams will also return to the Course Portal to take each end-of-
module exam.
Students preparing to take the examination for LOMA 335 will find that the assigned
study materials include many features designed to help learners more easily
understand the course content, organize their study, and prepare for the
examination. As we describe each of these features, we give you suggestions for
studying the material.
Learning Objectives. Each chapter lists the chapter’s learning objectives to help
you focus your studies. Before reading each chapter, review these learning
objectives. Then, as you read the chapter, look for material that will help you meet
https://www.loma.org/siteassets/pdfs/reference/textcorrections.pdf
Contents
Chapter 1
The Insurance Company and
Operations Management
Objectives
After studying this chapter, you should be able to
1 A Describe the stakeholders in an insurance company and how the primary
tenets of operations management apply to insurance operations
1 B Distinguish between primary and support operations and describe the
broad functions of operations employees
1 C Describe transactional work and knowledge workers and explain how
intellectual capital benefits a company
1 D Describe the elements in a value chain and explain how value chains are
used in operations management
1 E Define enterprise risk management (ERM) and explain the ERM process
1 F Describe changes in the insurance company operating environment and
strategies that insurers are implementing in response to these changes
Outline
Insurance Company Operations
Stakeholders
Operations Management
Functions of Operational Employees
The Value Chain
Enterprise Risk Management (ERM)
The ERM Process
ERM Evaluation
The Changing Operating Environment
Technology and Operations
New Market Competitors
Insurance Fraud and Cybersecurity
The Workforce
Regulatory Uncertainty
Economic Environment
The decisions insurers make relating to people, processes, and technology determine
whether an insurance company will operate profitably over the long term. Operations
management concerns managerial efforts to ensure that the products and services a
company provides to customers meet stated quality standards, are timely, and are
delivered profitably at the lowest reasonable cost to the company. Operational
excellence requires that companies continuously monitor, improve, and innovate
operations in order to be successful. This text describes key issues in operations
management and provides tools to aid in decision making.
Stakeholders
A stakeholder is any party to an organization that has an interest in how the company
conducts its business. Stakeholders can be external or internal to an organization.
They affect and can be affected by the organization’s decisions and include customers,
owners, employees, governments, suppliers, vendors, and partners. Figure 1.1
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Ch 1: The Insurance Company and
Operational Excellence for Insurance Professionals Operations Management | 1.5
identifies the primary insurance company stakeholders and describes what each
stakeholder typically wants in its relationship with the company.
the company having less money to spend in other areas. Even a decision to do
nothing involves forfeiting whatever value might have resulted from making a change
from the status quo. The challenge for management is to make decisions that are
within legal, ethical, and financial limits while maximizing stakeholders’ value and
minimizing costs to the company.
Operations Management
Quality, timeliness, and cost control are the primary tenets of general operations
management. However, service companies apply these concepts differently than do
manufacturing companies. A manufacturing company transforms raw materials into a
finished product that customers want or need and are willing to buy. In such a
company, profits are very product-centered and depend on the costs of the raw
materials needed to manufacture the products, the timeliness of the company’s
production and shipping methods, and the quality and innovation inherent in the
finished product.
Insurers create profits through the sale of intangible products and services.
Insurance products consist of an insurer’s contractual financial commitments as well
as services such as claim payments, interest payments, and expert and friendly
customer assistance. The elements of quality, timeliness, and cost control apply more
to the operations supporting these intangible insurance products than to the actual
product. Figure 1.2 shows insurance company operations categorized as either
primary or support operations. Note that company operations may be categorized
differently but these are typical categories. Primary and support operations both
contribute to the overall success and profitability of the insurance company.
EXAMPLE
The information/technology department incorrectly designs a compliance
feature into the system for a new product. New product sales suffer when the
product’s rollout is delayed.
The legal department is slow to approve the contract for a new product idea.
New product sales suffer when a competitor enters the market first with a
similar product.
EXAMPLES
The accounting/payroll function processes compensation payments for all
employees within a company.
The compliance function maintains licensing and compliance records for
sales professionals.
EXAMPLES
The policy administration function explains policy riders and endorsements
to a policyowner.
The claims administration function pays an insurance policy claim.
EXAMPLE
A product development director leads a cross-departmental team of
insurance professionals to create a new retirement annuity.
Resource inputs are any elements used to create a product or service. For
insurance, these inputs include receipts such as monetary investments from owners
and revenues from customers; labor and knowledge from employees; and
information, data, and technology. Transformative processes transform inputs into
outputs for customers. A process is a series of ongoing operations, work activities, or
tasks ordered in a definite sequence and directed toward achieving an end result. For
example, the activities involved in the claims process have the end result of fulfilling an
insurer’s contractual promises to an insurance policy customer. Outputs are the
desired results of a transformative process and can include satisfied customers,
satisfied employees, goodwill, profits, and investment growth. The three elements of
resource inputs, transformative processes, and outputs can be used to analyze a
company’s operations. Figure 1.4 presents a simplified value chain diagram for
insurance claims processing.
A value chain allows a company to analyze each link in the chain and determine
which processes or activities are adding value to a customer and which processes
might be improved or eliminated. As resources pass through each link in the value
chain, the resources accrue added value from the transformative processes the
company applies to the resources. Value chain activities are those that a company
considers as directly impacting customers. Note that companies vary in which
functions they classify as value-adding.
The more value a company creates, the more profitable the company is likely to
be. Analyzing a value chain allows management to look for links between activities and
functions and to design ways to improve efficiency and customer value. A value chain
is also helpful for analyzing the interrelationships between company functions. For
example, insurance companies know that there is a direct link between the quality of
customer service and sales and distribution. An investment in technology that
personalizes customer service activities in ways that please customers will likely result
in increased or retained business and add value to the company.
EXAMPLE
External Risk
The EndiFirst Insurance Company is subject to investment risk—the risk that the
overall market for stocks or bonds will decline in value, negatively affecting its
investments in stocks and bonds. EndiFirst uses the investment strategies of asset
allocation and diversification to help minimize investment risks.
Companies are also subject to internal risk. Operational risk is the potential for
financial losses resulting from inadequate or failed processes and controls, people, or
systems.
EXAMPLE
Operational Risk
The EndiFirst Insurance Company is considering outsourcing some of its
underwriting process to a third-party vendor. The vendor offers the latest
technology for processing, but EndiFirst is weighing various risks associated with
outsourcing this process. Among the questions raised:
—Will the vendor’s systems and business practices adequately protect the
confidentiality and security of customer data?
—Will the vendor adhere to EndiFirst’s underwriting policies regarding the
products being sold?
With limited control over the outsourced underwriting process, EndiFirst might be
financially responsible for data breaches and for higher than anticipated mortality
costs. Poor service quality also could damage EndiFirst’s reputation with
customers and ultimately sales. EndiFirst measures the potential for these risks
against the benefits of outsourcing the process.
Companies cannot eliminate risks but they can create systems for identifying and
managing risks. Enterprise risk management (ERM) is a system that identifies and
quantifies risks from both potential threats and potential opportunities and manages
risks in a coordinated approach that supports an organization’s strategic objectives.
When operating in an environment of decreased profit margins and increased
stakeholder scrutiny, the need for identifying and reducing risk is perhaps greater
than ever.
Insurance companies have many tools for identifying financial risk. For example,
insurers can conduct mathematical analysis to identify the sensitivity of the company’s
cash flows or stock value against risk factors such as interest rate or currency
fluctuations. How do companies identify operational risk?
INSIGHT
Analysis of Operational Risk
Operational risk is harder to identify and quantify than financial risk. Insurers
often ask each functional area to identify its top three to five operational risks
and then assess those risks using the following questions:
ERM analysis determines which risks are manageable with current organizational
strategies and processes, and which ones fall outside current methods. The outliers
are often new or emerging risks that have the most uncertainty associated with them.
To determine strategies for handling these risks, companies often engage in modeling
scenarios in various conditions of uncertainty. Chapter 8 describes modeling in
greater detail.
EXAMPLE
Modeling a Risk
The EndiFirst Insurance Company is reviewing its readiness for the
implementation of new tax policies in the United States. EndiFirst models the
following scenarios:
—10% chance of the current tax system remaining unchanged
—40% chance of new regulations changing tax rates for companies only
—50% chance of new regulations changing tax rates for individuals as well as
companies
EndiFirst analyzes each scenario to better understand its exposure and to
determine a course of action for the company should that option materialize.
The result of the modeling process may suggest that the company implement any
number of new strategies; including investing in a new technology, discontinuing a
marketing plan, or hiring someone with specialized expertise to monitor or manage
the risk.
ERM Evaluation
ERM assists a company in planning and determining which risks are critical.
Companies evaluate potential strategies for handling risks by evaluating the effects on
company stakeholders of different strategies. Although the impact of a risk on the
company’s customers is of primary importance, ERM evaluation must also consider
other stakeholders’ interests. Stakeholders often have common interests but
sometimes their interests can be in conflict with each other.
For example, the policyowners (customers) of an insurance company are primarily
interested in the company’s solvency over the long term. Their interests suggest that
an insurer maintain high levels of capital and reserves to ensure solvency regardless
of what risks might occur in the future. Owners of stock life insurance companies,
however, are interested in profits and growth. They want to maintain the minimum
required reserves and invest excess capital for higher returns. In this example of
conflicting interests, management must balance the risk of insolvency with the need
for investment returns. ERM attempts to quantify the risks in such decisions by using
modeling to identify alternatives with the greatest value and lowest risk potential.
Once modeling is complete, management selects the optimum strategy or
combination of strategies.
For insurance companies in the business of managing other people’s risks, ERM
would seem to be a logical process for all companies to follow. Surprisingly, a recent
survey found that only 46 percent consider the interaction of risk sources from the
financial and operational sides of the enterprise when assessing and measuring risk.
However, the percentage of insurers utilizing ERM is likely to increase as insurers face
potential disruptions in the insurance business.
Technology is the driving force behind much of the disruption in the insurance
industry. Technology has opened the door for new market competitors to enter and
created new opportunities for fraud. Other forces, such as a changing workforce,
regulatory uncertainty, and the continued low-interest-rate environment are adding
complexity to an already challenging operating environment.
The goal of AI is to go beyond automation and design processes for activities that
previously required human intelligence. For example, a chatbox is a system that uses
AI and spoken language or text to answer the most commonly asked customer
questions. When companies use AI, workers can focus their efforts more effectively on
less routine activities. Insurers also use AI to gain new insights into customers and
their behaviors that can lead to improved customer service, claims processing, and
underwriting operations.
The most common operational problem insurers face in connection with
technological change is whether to modify or replace the extensive and expensive
technology already in place in established companies. Legacy systems are older
computer systems or applications that perform essential functions and are costly to
replace or redesign. In addition to the financial costs of changing systems, established
companies have company cultures associated with these systems and established
operational processes that are often difficult to change.
Technology can create efficiencies in operations and drive increased market share
and company growth. However, a company must have a coordinated technology and
data strategy for operations to achieve the maximum return on investment.
Source: Adapted from Vijay Govindarajan, “The Three-Box Solution: A Strategy for
Leading Innovation,” Boston, MA: Harvard Business School Publishing, 2016. Used with
permission.
Figure 1-7 Description
Successful companies often focus on Box 1 because their success comes from
optimizing what they are currently doing. Govindarajan cautions that such companies
need to manage their present business for profitability but always be looking to the
future. To ensure continued success, Govindarajan recommends that companies let
go of attitudes and assumptions that might fuel current business but interfere with
future innovation. Box 2 requires companies to discontinue activities or even lines of
business that might be successful today but are unlikely to be successful in the future
because some aspect of the environment is changing. Box 2 requires difficult and
often painful decisions. Box 3 is where a company’s future lies. Focusing the
company’s attention on new ideas and innovations allows companies to create new
products and business models that take advantage of new or emerging technologies.
Box 3 represents how a company remains relevant in the future.
EXAMPLES
Using Technology to Identify Fraud
The EndiFirst Insurance Company uses data analytics to identify life insurance
policies submitted without an accompanying initial premium, which is a red flag
for an unauthorized policy.
EndiFirst also is utilizing Endpoint Detection and Response (EDR) technology to
detect, investigate, and respond swiftly to suspicious activities and issues at
network sites.
The Workforce
Workforce demographics have changed, as illustrated in Figure 1.8, and these changes
present challenges for operations management.
Source: Richard Fry, Pew Research Center, “Millennials Are the Largest Generation in
the U.S. Labor Force,” 11 April 2018, http://www.pewresearch.org/fact-
tank/2018/04/11/millennials-largest-generation-us-labor-force/
Figure 1-8 Description
The Millennial population (those people born from the early 1980s until 2000) has
now surpassed the baby boomer population (those people born from 1946 until 1964)
as the largest living population segment. Millennials, as a whole, have been slow to
adopt many of the markers commonly associated with baby boomer adulthood, such
Regulatory Uncertainty
Well-designed regulations are beneficial to customers and to market participants.
Some regulations create opportunities for the insurance industry. For example, the
passage of the Employee Retirement Income Security Act of 1974 created individual
retirement accounts (IRAs).
Yet regulation also has the potential to disrupt insurance operations. For example,
in 2015, the Department of Labor’s now abandoned fiduciary rule addressed the
potential for conflicts of interest in commission-based compensation structures by
requiring financial professionals who provide retirement investment advice to follow
specific steps designed to enhance transparency. In response, some companies
changed their operations and compensation structures, while others completely
exited certain distribution channels or discontinued some products. Experts believe
that this rule was a factor in the decline of variable annuity sales by 21% from 2015
to 2016. As the political environment remains volatile, regulatory uncertainty will
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Ch 1: The Insurance Company and
Operational Excellence for Insurance Professionals Operations Management | 1.31
Economic Environment
Life insurance companies collect premium income and hold some of this money as
reserves to pay benefits when they come due. Insurers invest the money they hold in
excess of reserves. However, they must invest funds cautiously to ensure that they will
have the funds available should benefit payments be greater than expected. As a
result, insurers invest conservatively, with a significant amount invested in interest-
bearing bonds such as U.S. Treasury bonds. Since the Great Recession in 2008, bond
interest rates have been at historic lows. For example, in April 2017, Treasury bonds
were trading at 2.28 percent.
What does this mean for an insurer’s operations? Insurers sold products during
the 1970s, 1980s, and even 1990s with a pricing structure that assumed a much higher
interest rate for investment income than was actually earned. With investment income
lower than anticipated, insurers need to operate more efficiently and less expensively
in order to remain profitable.
Conclusion
Chapter 1 provides an introduction to operations management and describes some of
the greatest challenges facing insurance company operations. Employees at all levels
of an insurance company play a role in facing these challenges. Later chapters provide
information and techniques to assist employees in this process.
Key Terms
operations management
operations
stakeholder
opportunity cost
transactional work
automation
knowledge workers
intellectual capital
value chain
process
operational risk
enterprise risk management (ERM)
artificial intelligence (AI)
chatbox
legacy systems
hacking
cybersecurity
gig economy
Learning Objective: 1B. Distinguish between primary and support operations and describe the
broad functions of operations employees.
2. Insurance company operations can be categorized as primary operations or support operations. Select
the answer choice that correctly identifies an example of primary operations and an example of
support operations.
Primary operations Support operations
(1) underwriting sales and distribution
(2) customer retention accounting
(3) internal control product development and implementation
(4) human resources information technology
Learning Objective: 1C. Describe transactional work and knowledge workers and explain how
intellectual capital benefits a company.
3. The following statement(s) can correctly be made about transactional work and knowledge workers:
A. Transactional work often allows a great deal of flexibility in how processes are completed.
B. Knowledge workers tend to be self-managing and continuously innovating.
(1) Both A and B
(2) A only
(3) B only
(4) Neither A nor B
Learning Objective: 1D. Describe the elements in a value chain and explain how value chains are
used in operations management.
4. The value chain, proposed by Michael Porter, refers to a set of activities that a company carries out
to create stakeholder value. This model consists of three main parts: resource inputs, transformative
processes, and outputs. Examples of outputs for insurance companies generally include
(1) goodwill
(2) claim processing
(3) technology
(4) investment management
Learning Objective: 1E. Define enterprise risk management (ERM) and explain the ERM process.
5. Insurance company operations are subject to a host of internal and external risks. The potential for
financial losses resulting from inadequate or failed company processes and controls is known as
(1) regulatory risk, which is a type of internal risk
(2) regulatory risk, which is a type of external risk
(3) operational risk, which is a type of internal risk
(4) operational risk, which is a type of external risk
Learning Objective: 1F. Describe changes in the insurance company operating environment and
strategies that insurers are implementing in response to these changes.
6. The following statements are about the changing operating environment for insurers. Three
statements are true, and one statement is false. Select the answer choice containing the FALSE
statement.
(1) Insurers are analyzing every aspect of their value chains to see how they might use new
technologies to realign operations and deliver greater customer value.
(2) The most common operational problem insurers face in connection with technological change
is whether to modify or replace legacy systems.
(3) The goal of artificial intelligence (AI) is to automate transactional tasks that normally require
human intervention.
(4) Fraud detection and prevention in life insurance company operations are increasingly
important.
7. The following statements are about new market competitors, the changing workforce, regulations,
and the economic environment, which impact insurance operations management. Select the answer
containing the correct statement.
(1) According to the three-box solution proposed by Vijay Govindarajan, a Dartmouth College
professor, Box 1 requires companies to discontinue activities or even lines of business that
might be successful today but are unlikely to be successful in the future.
(2) Millennials are active participants in the gig economy.
(3) Although the political environment remains volatile, regulatory uncertainty is likely to go
away.
(4) Because future investment income is likely to be much higher than anticipated, insurers will
more easily be able to manage benefit payments.
Chapter 2
Aligning Operations with Corporate
Strategies
Objectives
After studying this chapter, you should be able to
2 A Describe the role of the corporate mission, goals, and strategies in the
management cycle
2 B Distinguish between the strategic management cycle and the operational
management cycle
2 C Describe steering, concurrent, and feedback control systems and their
role in maintaining a strategically aligned company
2 D Describe the benefits of strategic alignment, the potential for
misalignment, and how to correct misalignment
2 E Describe a market and explain how insurers use market share and
industry competitiveness in evaluating markets
2 F Distinguish between incremental and breakthrough innovation strategies
and explain why both are important to insurers
Outline
The Four Functions of Management
Strategic Management
Operations Management
Control Systems
Performance Standards
Steering Controls
Concurrent Controls
Feedback Controls
A Strategically Aligned Company
The Potential for Misalignment
The Strategic Alignment Matrix
Correcting Misalignment
The Environment of Strategy
The Market
Market Share
Industry Competitiveness
Innovation Strategy
Stacy Dominick is the chief accounting officer for the EndiFirst Life
Insurance Company, and Tom Ward is the claims manager. Do you think
Ms. Dominick or Mr. Ward spends more time on the directing function of
management?
A. Ms. Dominick
B. Mr. Ward
Strategic Management
A company’s strategic management, or top levels of corporate management,
evaluates the company’s mission and business goals in order to formulate plans for
the business. The mission of an insurance company is to satisfy customer needs for
managing risk. Each insurer attempts to satisfy customer needs in its own unique way.
Some focus on customer service or low cost. Others create unique products for
specialized needs. The corporate mission is how the company will satisfy customer
needs and is expressed in the company’s mission statement—a statement of a
company’s fundamental purpose or reason for existence.
Planning
Planning at the strategic level requires knowledge about the environment in which the
company operates. Management creates strategic plans in accordance with economic,
political, and legal considerations in the company’s external environment. Strategic
management must also consider the competitive environment in which the company
operates. All of a company’s strategic planning efforts should support the corporate
mission.
The broad planning targets a company attempts to achieve in support of the
corporate mission are corporate goals, or corporate objectives.
Corporate strategies usually extend at least three to five years into the future.
Long-term plans, however, are always subject to change as circumstances in a
company’s environment change. For example, EndiFirst taking longer than anticipated
to research and purchase the technology it needs would delay the accomplishment of
other strategies.
Business strategies are action plans for a line of business, such as a product line,
business unit, or strategic business unit (SBU). In insurance companies, a product line
might consist of individual life insurance and annuities or property and casualty
insurance. Business strategies must carefully align to support corporate strategies.
Controlling
Controls at the strategic level tend to be broadly based guidelines and policies for the
organization as a whole or for major organizational subunits such as an SBU or a
product line department. For example, the corporate budget acts as a control as it
sets the total limit for what operations can spend. Lower levels of management
determine day-to-day operations within these strategic guidelines and policies.
Operations Management
Operations management must fully understand the company’s mission, goals, plans,
and strategies to keep operations functioning correctly within the overall strategic
framework. The four functions of management apply somewhat differently at the
operations level than at the strategic level, as follows:
Planning
Planning has a much narrower focus at the operational level. An operational strategy
is a general action plan for day-to-day activities that must occur within a budget
dictated by the company’s strategic plans. Operational strategies often extend for only
one or two years into the future.
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Ch 2: Aligning Operations with Corporate
Operational Excellence for Insurance Professionals Strategies | 2.9
Organizing
Organizing at the operational level consists of creating processes, scheduling
activities, staffing activities, and allocating budgeted resources. In a typical
organization, operational managers do not have authority to exceed the established
budget. Operational managers use tactics for organizing operational work. A tactic is
an action designed to support an operational strategy. A tactic describes the specifics
of a plan, such as which staff member will take a certain action by a specific time.
EndiFirst Tactics
- Tactic 1: Product development manager will hire a new digital unit manager to
head a digital product development unit by October 1, 20XX.
- Tactic 2: Digital unit manager will have initial draft of a digital product
development plan ready by December 1, 20XX for product development manager
to review and finalize by January 1, 20XX.
- Tactic 3: Digital unit manager will schedule weekly meetings with the digital unit
so that everyone can report on goals and accomplishments and make
adjustments as necessary to keep the digital product development plan on track.
Functional Expertise
John Downing, the new manager for the digital project development unit, has
worked in product development for 20 years. Most recently he worked with a
technology company, and EndiFirst hired him because of his knowledge of digital
systems and ability to problem solve. When Mr. Downing provides guidance to his
team members or reviews a team member’s work, his opinions and
recommendations are highly respected and easily accepted because of his
functional expertise.
A general plan for day-to-day activities that must occur within a stated
budget is an example of
A. An operational strategy
B. A tactic
Control Systems
Strategic and operational managers use control systems to keep company activities
aligned with corporate goals and strategies and moving in the right direction. A
company uses a system of steering controls, concurrent controls, and feedback
controls to achieve these objectives. Figure 2.1 provides some examples of controls.
Feedback controls focus on the past and as such are reactive controls. Concurrent
controls focus on the present. Steering controls are proactive controls designed to
guide future activities. Note that whether a control is a feedback, concurrent, or
steering control often depends on how it is used. For example, a budget can be a
steering control for planning, a concurrent control for day-to-day operations, and a
feedback control once a budget cycle is completed.
goals for an activity that are specific, measurable, and relevant. A performance
standardis an established level of performance to which a company or an individual
compares actual performance. When a performance standard for a process or activity
is critical to a company’s success, it is a key performance indicator (KPI). Chapter 4
explains how companies identify and carefully monitor KPIs. Performance standards
may be objective or subjective. The more subjective the performance standard, the
more difficult it is to measure performance, and ultimately improve performance.
EXAMPLE
Subjective vs. Objective Performance Standards
EndiFirst requires an annual performance evaluation for each employee.
Some employees are assessed on objective quantifiable goals, e.g., answers X
number of calls per day, processes X number of applications without errors per day.
Managers of these employees can measure an employee’s performance and
recommend specific ways to improve performance.
Other employees are evaluated on the quality or innovation inherent in their
work, which is more subjective. Nonetheless, managers of these employees must
determine quantifiable goals for evaluating an employee’s work. A quantifiable
measurement for this type of work might be to submit two innovation ideas to the
innovation steering committee quarterly, to provide biweekly control reports by the stated
deadline, or to receive positive feedback from peers or industry stakeholders who deal
directly with the employee.
Steering Controls
Steering controls proactively communicate expectations and try to prevent problems
from occurring. Steering controls provide performance guidance to all levels of a
company. At the corporate level, a code of conduct—a formal statement of a
company’s core values and its expectations for how its employees should behave in
the course of business—is an example of a steering control. The budget is also a
steering control in that it sets priorities and constraints for a company’s future
operations.
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Ch 2: Aligning Operations with Corporate
Operational Excellence for Insurance Professionals Strategies | 2.14
EXAMPLE
EndiFirst’s Code of Conduct
EndiFirst’s Code of Conduct describes employee behaviors that represent a
conflict of interest and provides specific examples. A conflict of interest exists
when the interests or actions of one entity, such as an employee, are
incompatible with the interests or actions of a related entity, such as an employer.
Example of Prohibited Behavior: An employee shall not accept gifts from vendors or
suppliers unless such a gift has a value of less than $20.
Potential Conflict of Interest: A valuable gift might encourage an employee to treat a
supplier or vendor as a preferred partner even if the services or products provided by the
supplier or vendor are not favorable to the company.
By educating employees about conflicts of interest, and providing specific
examples of prohibited behaviors, employees are better able to avoid such
conflicts.
Many companies require annual code of conduct reviews; some require
employees to complete a conflict-of-interest questionnaire each year.
Concurrent Controls
Concurrent controls continuously monitor a company’s activities and systems as they
are being performed to ensure that an activity is meeting established performance
standards or complying with established procedures.
EXAMPLES
Concurrent Control
A manager in an insurer’s customer contact center listens to real-time
conversations and provides feedback to an employee as the conversation takes
place.
An underwriting manager, or more experienced underwriter, reviews and helps a
new underwriter correct a case before it is sent for approval.
Real-time customer call statistics are monitored to determine appropriate staffing
levels for call volume.
An operations manager reviews expenses quarterly against the budget to ensure
that her department remains within the budget’s guidelines.
EXAMPLE
Concurrent Exception Report
A claims processing system processes and automatically pays certain claims
according to rules relating to such things as claim amount and contestability.
Exceptions to the system’s rules are flagged for human review.
A customer service system triggers an alert when a service representative
exceeds a maximum time limit with a customer so that a manager can offer
assistance to the service representative in handling the call.
Feedback Controls
Feedback is using information about past operations to change future operations.
Feedback controls compare actual performance or output with established standards
at the end of a measurement period.
EXAMPLE
Feedback Control
The Fine Life Insurance Company has established a goal of decreasing the number
of customer complaints by 10% from the previous year. Fine logs customer
complaints into a central repository at the end of each day. The complaints are
analyzed the next day to rectify any identified problems or to make improvements
as needed to related processes.
The ABC Life Insurance Company has various operational controls that
can be classified as steering controls, concurrent controls, or feedback
controls. When ABC Life uses management by exception techniques to
identify unacceptable performance at the end of an evaluation period, it
is using a type of
A. Steering control
B. Concurrent control
C. Feedback control
Source: Jonathon Trevor and Barry Varcoe, “A Simple Way to Test Your Company’s
Alignment,” Harvard Business Review, 16 May 2017, https://hbr.org/2016/05/a-simple-
way-to-test-your-companys-strategic-alignment (9 November 2017).
Figure 2-3 Description
Correcting Misalignment
Correcting misalignment often requires that company leaders make tough choices
about the company’s purpose, people, and processes, which can involve significant
organizational and operational changes. Management uses questions like those
outlined in Figure 2.2 to identify the areas that require change. Strategic management
then creates plans designed to accomplish those changes and communicates the
plans to employees.
Organizational realignment often breaks down when communicating these
changes to employees. Unless employees understand the importance of the change
strategies and believe the strategies will work to accomplish a stated goal that is
beneficial to the company and to employees, company morale will suffer. Strong
leadership and honest communication are necessary, as are policies that reward
desired behaviors. Later chapters delve more deeply into the leadership, company
culture, and changing business processes that are required to keep a company
aligned or correct misalignment.
EXAMPLE
Realignment
The Fine Life Insurance Company’s mission is to provide insurance products with
the highest level of quality service at affordable prices. Initially, the goal of quality
customer service was clear in company strategies. However, as time passed, the
company instituted many strategies designed for operational efficiencies. Over
time, the decisions made to improve operational efficiency negatively affected the
quality of service. To realign its purpose and its strategies, Fine Life Insurance had
to refocus its processes on how to provide quality service. Among the actions
taken during realignment were
—Determining customers’ wants and needs
—Hiring additional employees
—Retraining existing employees
—Providing employees with meaningful rewards for providing quality service
—Implementing new automated processes that provide customization of services
to customer needs
The Market
A market is a physical or virtual area in which buyers and sellers of a particular good
or service interact to exchange resources. The insurance market in which insurance
companies operate varies widely. The market may be the world, a country, a
geographic region within a country, or a city. Very large insurance companies may
consider their relevant markets to be most of the countries in the world. Smaller
insurance companies might only compete in regional markets within one country.
Some companies may compete only in one state or region. Companies determine the
market or markets in which they wish to participate based on how well they can
compete in a given market given certain favorable market and product characteristics,
which are illustrated in Figure 2.4.
Market Share
A company’s competitive success is often measured in terms of market share—the
percentage of an industry or market’s total sales that is earned by a particular
company over a specified time period. Market share is calculated as
Company’s sales over a designated
period
= Market Share
Total sales in company’s industry
over same designated period
Market leadership refers to a company’s position relative to its competitors in
terms of market share percentage. The company with the greatest percentage market
share is the industry leader.
It is very easy for market leaders, like Insurer A, to focus on current customers and
successful operations—what we referred to as Box 1 operations in Chapter 1. However,
successful companies also need to consider the unsatisfied needs of customers and
noncustomers (Box 3 activities) in order to create future opportunities that will allow
the company to remain profitable over the long term. Consider that Blockbuster’s
customers did not know they wanted the convenience of not leaving home to rent a
movie until presented with that option. As some insurance products become easier to
buy online, the potential for disruption in the insurance market from nontraditional
competitors grows ever greater. Insurers must be willing to disrupt their own
insurance business models in order to remain relevant.
Industry Competitiveness
The level of competition within an industry can influence strategic decisions about
whether to enter a new market or remain in a market. Companies can use a
concentration ratio, which measures the sum of the percentage market shares of the
top companies in the industry to determine industry competitiveness. , Typically, the
percentage market shares for the top three or four companies in an industry are used
to calculate the ratio. The higher the concentration ratio, the less competitive the
industry. The concentration ratio for the insurance industry using the four top
insurers shown in the previous example is as follows:
advertising and other marketing efforts. The insurance industry has traditionally had
monopolistic competition. When the concentration ratio rises above 80 percent but
remains below 100 percent, the market is categorized as an oligopoly—a market with
few sellers of similar products or services, vigorous advertising, and many barriers to
entry for new sellers. As in monopolistic competition, companies would prefer not to
get into a price war with other companies and so they seek to create non-price
differences between their products and services and those of other companies
through advertising and marketing. If one company or a group of related companies
has 100 percent of the market share, then the industry is categorized as a monopoly—
a market in which one firm, or a group of firms acting together, controls the
production and distribution of a product. Advertising and marketing are not as
important to a monopoly because of the lack of competition. Figure 2.5 summarizes
these levels of competition.
Barriers to entry are obstacles to a new seller’s entry into a market. In the
insurance industry, regulations present a barrier to entry. For example, insurers are
subject to licensing requirements, reserve requirements, and many other regulations.
Advertising is a way for sellers in conditions of monopolistic competition or oligopoly
to create a perception of differences between sellers, services, or products when price
competition is limited. In the insurance industry, customers often have difficulty
understanding price differences, and regulations limit the degree to which insurers
can compete on price and product differentiation.
Innovation Strategy
In a challenging operating environment, insurers may find it hard to anticipate and
plan for the future. However, preparing for the future is a prerequisite for future
success. As a result, more and more companies are incorporating innovation into
their corporate goals and creating corporate strategies for innovation. Many
companies are also creating vision statements. A vision statementis a declaration of
where a company would like to be in the future. Whereas the mission statement
pertains to where a company is now, a vision statement is more like a guidepost for
future operations. Vision statements are most useful in motivating employees to
embrace a common concept for the company’s future.
Key Terms
mission statement
board of directors (BOD)
corporate goals
corporate strategy
competitive advantage
business strategies
operational strategy
tactic
performance standard
key performance indicator (KPI)
steering controls
code of conduct
conflict of interest
procedure
job description
concurrent controls
exception report
feedback controls
management by exception
corporate governance
silos
market
substitute products
market share
market leadership
concentration ratio
monopolistic competition
oligopoly
monopoly
barriers to entry
vision statement
breakthrough innovation
incremental innovation
1. The following statements are about the role of the corporate mission, corporate goals, and corporate
strategies. Three statements are true, and one statement is false. Select the answer choice containing
the FALSE statement.
(1) A company’s mission statement states the company’s fundamental purpose or reason for
existence.
(2) Corporate goals are the broad planning targets a company attempts to achieve in support of the
corporate mission.
(3) Corporate strategies usually relate to the market in which the company is operating, or in which
it plans to operate in the future.
(4) Corporate strategies usually extend for only one or two years into the future.
Learning Objective: 2B. Distinguish between the strategic management cycle and the operational
management cycle.
2. All levels of management, whether strategic or operational, include four functions of management:
planning, organizing, directing, and controlling. Compared to planning at the strategic level,
planning at the operational level has a much (narrower / wider) focus. An operations manager
spends the majority of his time (planning and organizing / directing and controlling) the work of
his subordinates.
(1) narrower / planning and organizing
(2) narrower / directing and controlling
(3) wider / planning and organizing
(4) wider / directing and controlling
Learning Objective: 2C. Describe steering, concurrent, and feedback control systems and their
role in maintaining a strategically aligned company.
3. A company uses a system of steering controls, concurrent controls, and feedback controls to achieve
corporate goals. With regard to the control system, it is correct to say that steering controls
(1) are used to communicate a company’s performance expectations
(2) indicate whether activities being performed are meeting established performance standards
(3) take place at the end of a measurement period
(4) use information about past operations to change future operations
Learning Objective: 2D. Describe the benefits of strategic alignment, the potential for
misalignment, and how to correct misalignment.
4. Maintaining strategic alignment is a primary concern for a company’s management. One aspect of
this effort is corporate governance, which is primarily the responsibility of a company’s (board of
directors / operational managers). Misalignment can occur when operational employees operate in
(silos / barriers to entry), which refer to operational units that act in isolation from other operational
units.
(1) board of directors / silos
(2) board of directors / barriers to entry
(3) operational managers / silos
(4) operational managers / barriers to entry
Learning Objective: 2E. Describe a market and explain how insurers use market share and
industry competitiveness in evaluating markets.
6. Companies determine the market or markets in which they wish to participate based on how well
they can compete in a given market given certain favorable market and product characteristics. In
general, a market presents a favorable market characteristic when
(1) the market has many substitute products
(2) the market has few sellers
(3) a company has no flexibility in product pricing
(4) consumers have no urgent need for a company’s products
7. In one insurance market, the following insurance companies hold 85% of the total industry premiums
written:
Company A: 30% of total premiums written
Company B: 25% of total premiums written
Company C: 17% of total premiums written
Company D: 13% of total premiums written
In this market, the concentration ratio for the top three companies is equal to
(1) 55%, which indicates monopolistic competition
(2) 55%, which indicates oligopolistic competition
(3) 72%, which indicates monopolistic competition
(4) 72%, which indicates oligopolistic competition
Learning Objective: 2F. Distinguish between incremental and breakthrough innovation strategies
and explain why both are important to insurers.
9. Innovation goals and strategies focus on different types of innovation. Innovation that can change a
company’s business model is (breakthrough / incremental) innovation. For operations
management, (breakthrough / incremental) innovations are the primary focus.
(1) breakthrough / breakthrough
(2) breakthrough / incremental
(3) incremental / breakthrough
(4) incremental / incremental
Chapter 3
Creating a Culture of Excellence
Objectives
After studying this chapter, you should be able to
3 A Explain the importance of trust in effective leadership and ways that
leaders build trust and use power in the workplace
3 B Describe the types of influence tactics leaders use in the workplace
3 C Describe how individuals can modify their own behavior and that of
others by using the eight practices of effective leaders and managing
antecedents and consequences in the workplace
3 D Explain self-determination theory and expectancy theory and describe
the role of motivation in work performance
3 E Describe the performance evaluation process, its role in motivating
employees, and problems often encountered during performance
evaluation
3 F Identify different types of compensation and explain how companies link
performance evaluation to compensation systems to motivate employees
3 G Describe the dimensions of a job and approaches to job design and work
arrangements that companies use to motivate employees
3 H Describe workgroups, the characteristics of cohesive groups, and the
group development process
3 I Describe the benefits of employee engagement and how companies can
enhance employee engagement
3 J Explain the role of organizational values in encouraging trust, respect, and
openness in the workplace and ways that companies can discourage bullying
and sexual harassment
Outline
Effective Leaders
Trust
Power
Behavior Modification
Influence Tactics
Eight Practices of Effective Leaders
Managing Antecedents and Consequences
Motivation Theories
Self-Determination Theory
Expectancy Theory
Motivating Through Evaluation and Compensation
Performance Evaluation
Compensation
Motivating Through Job Design
Approaches to Job Design
Nontraditional Work Arrangements
Group Dynamics
Cohesiveness
Group Development
Organizational Values
Employee Engagement
The Work Environment
Ultimately, people are responsible for carrying out corporate strategies and
operational tasks. As a result, an insurance company needs effective leaders who can
create a corporate culture that aligns with corporate strategies and motivates
employees. A corporate culture comprises the attitudes, values, perceptions, beliefs,
and experiences shared by a company’s employees and instilled in new employees
when they join the company. The corporate culture can promote or discourage
certain behaviors in the workplace and directly influence the success or failure of
corporate strategies. For example, if the company culture encourages putting the
customer first, employees will be motivated to support corporate strategies that
emphasize innovative ways to improve the customer experience. On the other hand, if
the company culture focuses primarily on cost savings or avoiding failure, employees
likely won’t spend time developing innovative customer-centric strategies.
How can an insurance company create a culture that aligns with corporate
strategies? The company needs effective leaders who motivate employees, maximize
the productivity of groups, and create a healthy work environment that engages
employees.
Effective Leaders
A leader is a person who influences other people toward the achievement of a vision
or set of goals. Leadership in a company may be formal or informal. Formal
leadership refers to a person’s ability to influence the behavior of others through the
authority conveyed on that person by the company. Authority is the right to direct
others. For example, a manager has the formal authority to evaluate employees’ work
and use financial and nonfinancial means to direct employee behavior. Informal
leadership is the ability to influence the behavior of others by means other than the
formal authority that an organization has conferred. For example, an informal leader
may influence the behavior of others by being an inspiring role model for positive
workplace behaviors. Managers may be both formal and informal leaders.
Nonmanagers can act as informal leaders within a company and can be influential in
creating the corporate culture. We focus in this text, though, primarily on formal
leaders in management positions.
Trust
Management research has determined that trust is an essential characteristic that
effective leaders display. Trust refers to a belief in the integrity, character, or ability of
others. Integrity means that an individual acts in ways that are consistent with their
beliefs. Character refers to an individual’s care and support for other people. Ability
refers to an individual’s possession of the technical skills or knowledge to get a job
done.
When trust is present in a management/employee relationship, employees are
more productive. As a recent study found, “For 93% of employees, trust in their direct
boss is essential to staying satisfied at work, and over half of employees surveyed say
if they aren’t satisfied at work, they can’t put forth their best effort.” When trust is
present in a manager/employee relationship, employees are more likely to
Innovate. Employees are more willing to innovate because they trust their
managers won’t punish them for failures that might come from taking risks.
Share information. Employees are more willing to present differing opinions or
unpleasant facts because they do not fear negative repercussions.
Work well in groups. Employees who feel supported by their managers are
more likely to extend trust to others with whom they are working within a
group.
Results from a 2016 survey on trust in leadership in the United States show that 55
percent of employees do not trust senior leadership. When trust in leadership is
lacking, employees are less confident in management decisions and less passionately
engaged in their work. As a result, organizations experience higher levels of employee
dissatisfaction and employee turnover, and lower overall performance. The good
news is that managers can take steps to build trust with employees. They can
Align behaviors with values. Managers whose behaviors align with personal or
organizational values earn employee trust. For example, if teamwork is an
important organizational value, a manager needs to model collaborative
behaviors for employees personally and set up department processes that
promote employee teamwork.
Keep commitments. Managers who keep their promises to employees build
trust over time. Managers who say what they will do, and then do what they said
they were going to do, prove to employees that they are trustworthy.
Be honest. Managers who are honest with employees build trust. When
information is positive, managers find it easy to be honest, but being honest
about negative information tends to be more difficult. Employees, however, do
not like surprises about the organization or their work, and would prefer to
hear unpleasant news from a manager rather than through the company
grapevine.
Communicate. Communication involves asking questions, listening to answers,
and then following up with actions that prove that communication took place.
The relationship between a manager and an employee is only as good as the
communication that exists between the two. Trustworthy managers
communicate regularly with employees.
Be supportive. Managers who see employees as people first understand that
personal lives matter and that what is going on at home impacts job
performance. Managers build trust when they provide support to employees
during rough times and celebrate with employees during good times.
Give credit but take blame. An employee’s failure is most often the failure of
management. A failing employee may lack some needed training, guidance, or
resources. Managers who take the blame for failures but give appropriate credit
and rewards when employees succeed build trust with employees.
Power
Leaders have various types of power. Management literature recognizes five bases of
power in an organization: legitimate, reward, coercive, expert, and referent. The first
three types of power are formal powers associated with an individual’s position within
an organization. The last two types of power come from qualities inherent in an
individual and are types of personal power. Figure 3.1 describes these types of power.
The type of leadership power that exists because a person has earned
the loyalty, respect, and admiration of others is known as
A. Legitimate power
B. Reward power
C. Expert power
D. Referent power
Behavior Modification
Behavior modification refers to techniques used to encourage desirable behavior and
discourage undesirable behavior. According to behavior modification theory,
individuals can learn to become effective leaders by modifying their own behaviors.
Effective leaders can also use techniques, such as influence tactics and rewards, to
influence or modify the behaviors of others.
Influence Tactics
Effective leaders develop certain tactics for influencing others to act in specified ways,
and such leaders also recognize that certain tactics work better in some situations
than others. Nine commonly used influence tactics are shown below.
Overall, the most effective influence tactics tend to be rational persuasion and
consultation. Pressure tactics are rarely appropriate in the workplace unless other
methods of influencing an employee’s behavior have failed. For example, a manager
may need to threaten termination of employment if other methods of influence have
not changed an employee’s actions.
Any of these tactics may influence others to accept or agree to what a leader
wants in the short term. However, rational persuasion and consultation are the best
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Operational Excellence for Insurance Professionals Ch 3: Creating a Culture of Excellence | 3.11
tactics for motivating others and gaining acceptance or agreement over the long term.
the desired result, people often find a more efficient way to achieve it.
EXAMPLE
Customer Service Examples
Antecedent that prompts negative behavior: A computer system that freezes
periodically causes employees to complain to customers about the slow system,
which negatively affects the quality of customer service.
Antecedent that prompts positive behavior: A checklist of frequently asked
questions about a variable annuity product assists employees in answering
customer questions quickly and correctly.
Consequences
Behavioral theory shows that people tend to repeat behaviors that have favorable
consequences and avoid behaviors that have unfavorable consequences. Four
strategies for managing the consequences of behavior are positive reinforcement,
negative reinforcement, extinction, and punishment.
Positive reinforcement is the process of encouraging a specific behavior by
immediately following it with a consequence that the individual finds pleasing or
positive.
Tina Snow’s manager asked her to make a presentation during a group meeting.
Tina had never spoken in front of a group of people, and she felt anxious and
uncertain about doing the presentation. However, she did the presentation, and
her manager praised her for her good work. Tina felt proud of her presentation
and decided she would like to do more in the future.
Assume that before Tina made her presentation to the group, she asked her
manager to assign the presentation to someone else. The manager asked why,
and Tina said she felt anxious about standing in front of the group and being the
center of attention. The manager suggested that Tina create slides for her
presentation so that the slides and not Tina would be the focus. Tina felt
immediate relief from her anxiety, knowing that she could do the presentation
without having to be the focus of the group’s attention. She was suddenly
motivated to work hard on her presentation.
Assume that when Tina asked her manager to assign the presentation to
someone else, her manager threatened to take away her quarterly performance
bonus. In this case, Tina managed to do a presentation (she overcame her anxiety
about the presentation) but she was not motivated to do her best work.
Assume that Tina emailed her manager to ask that she assign the presentation to
someone else, and that the manager never responded to her emails. Eventually,
after getting no response, Tina accepted her fate and did the presentation but she
was not motivated to do her best work.
Negative reinforcement and punishment seem similar but they are not. In these
examples, Tina’s manager used negative reinforcement when she realized that Tina’s
unwillingness to do the presentation was due to her anxiety about standing in front of
the group. By removing the unpleasant aspect of the situation that was causing Tina’s
anxiety, Tina’s manager used negative reinforcement appropriately. People often use
EXAMPLE
Continuous and Intermittent Reinforcement
A supervisor in an underwriting department is training a new underwriter to use
the new business processing system. The supervisor initially uses continuous
reinforcement to praise or correct the employee’s behavior each time he
completes an application correctly. Once the employee appears to understand
the system, the supervisor uses intermittent reinforcement to ensure that the
correct behavior continues.
Motivation Theories
Motivation theory helps leaders understand that not everyone is motivated in the
same way. Motivation is the force that gives purpose and direction to an individual’s
behavior and can be classified as either intrinsic or extrinsic.
Intrinsic motivation is a force that causes an individual to initiate an activity for
its own sake, because the activity is satisfying to the individual. Intrinsic rewards
are positive outcomes that are self-granted and internally experienced. For
example, employees may feel a sense of accomplishment and increased self-
esteem while learning a new skill or mastering a challenging assignment.
Extrinsic motivation is a force that causes an individual to pursue an activity to
obtain an external goal. Extrinsic rewards are positive outcomes that other
people or organizations grant to an individual. Money, employee benefits,
promotions, or praise are examples of extrinsic rewards in the workplace.
Engaging in behavior to avoid a negative outcome, such as coming to work so
that you do not lose your job, is also an example of being motivated by an
extrinsic reward.
Examples of intrinsic and extrinsic rewards are shown in Figure 3.2.
Self-Determination Theory
The effects of intrinsic and extrinsic rewards can be seen in self-determination theory
(SDT)—a motivation theory that proposes that people have three basic psychological
needs. First, they have a need for competence—they want to know that they are
effective in dealing with their environment. Second, people need relatedness—close,
affectionate relationships with others. Finally, people need autonomy—to feel in
control of their lives.
SDT suggests that there are two types of motivation. Autonomous motivation
arises primarily from intrinsic rewards affiliated with needs for competence,
relatedness, and autonomy. For example, some employees take on extra
responsibilities to learn something new because they enjoy the challenge of gaining a
competency or want to form new relationships. When autonomous motivation is
involved, a person is highly motivated to engage in an activity. Controlled motivation
primarily involves extrinsic rewards. For example, when employees take on additional
tasks because they do not want to lose their jobs or they seek a promotion, controlled
motivation is involved. People are rarely motivated by only one type of motivation.
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Operational Excellence for Insurance Professionals Ch 3: Creating a Culture of Excellence | 3.18
Expectancy Theory
Another motivation theory, expectancy theory, states that the strength of an
individual’s tendency to act in a certain way depends on the individual’s expectation
that the act will be followed by a given outcome, and by the attractiveness of that
outcome to the individual. Expectancy theory suggests that an individual’s motivation
depends on effort, performance, and reward. Watch Video 3.2 to learn about
expectancy theory.
The effort component requires that employees have the skills and knowledge
necessary for performance. Leaders provide training and guidance to ensure that
employees feel confident in their abilities. Ensuring that employees have the right
resources, such as accurate information or efficient computer systems, to do their
jobs is also important.
The performance component requires that employees believe their effort will result
in a reward. Clear performance requirements and understandable performance
measurements are needed. Employees must trust that the process for assessment is
fair and that a good job will result in the promised reward.
Finally, the reward must be important to the employee. Rewards need to
incorporate extrinsic and intrinsic elements when possible to motivate high
performance. Pay and benefits—examples of extrinsic rewards—do affect motivation
in that people who are not paid adequately feel less motivated to perform at high
levels. However, studies show that pay and benefits do not significantly enhance
performance once employees achieve a certain minimum level of pay and benefits. For
such employees, incorporating elements into a job that promote feelings of
competency, relatedness, and autonomy often do enhance employee performance.
For example, a company might see performance improve when employees are
encouraged to spend an hour each week with coworkers on a special project of their
own choosing or provide access to training and education programs that will improve
competencies.
Performance Evaluation
Performance evaluation also plays a role in motivating employees if done correctly.
During a performance evaluation, a manager should
Establish clear goals and expectations for employee performance
Provide feedback to employees about their performance
Identify performance areas in which employees excel
Identify employee training and development needs
Determine the distribution of rewards, such as pay increases or bonuses
Goal-setting theory states that employees are motivated by challenging yet
attainable goals, along with appropriate feedback to mark progress toward those
goals. In addition, employees who participate in the process of setting goals typically
feel more positive about their goals. Management by objectives (MBO)is a
performance evaluation technique in which the employee and supervisor work
together to (1) set clear and attainable goals for the appraisal period and (2) develop a
plan for achieving those goals. When the individual’s objectives clearly support
strategic organizational objectives, MBO helps keep the organization aligned.
Ideally, each employee meets with a supervisor regularly during the evaluation
period to assess the employee’s progress in achieving goals and to determine if the
employee needs any assistance in order to meet the goals. With the rapid pace of
change in business today, goals themselves may also change during the evaluation
period. At the end of the evaluation period, typically annually, the employee and
supervisor evaluate the employee’s overall success in meeting established goals and
set goals for the next evaluation period.
For MBO to be effective, goals must be specific and measurable so that employees
know what they must do. A well-managed MBO program also provides employees with
objective, results-oriented feedback that can aid employee development. A problem
with MBO is that an effective MBO program is time-consuming for the supervisor to
manage.
How frequently an employee receives performance feedback during the evaluation
period depends on the employee. For example, new employees may benefit from daily
or weekly feedback, whereas more experienced employees may only need monthly or
even less frequent feedback. Regardless of the frequency, regular interactions
between a supervisor and employee promote communication, build trust, and
provide a supervisor with an opportunity to provide ongoing positive reinforcement.
In general, an employee should not hear positive or negative performance-related
information for the first time at an annual performance review.
For employees who are experiencing difficulties with one or more aspects of their
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Operational Excellence for Insurance Professionals Ch 3: Creating a Culture of Excellence | 3.23
job, or who want to develop new skills, a supervisor may use coaching. Coachingis a
process in which a supervisor works with an employee to improve performance on the
job. Coaching is typically short-term, focusing on new job skills or on improving
competency in a job skill. Once that skill is learned, the coaching ends. When effective,
coaching motivates employees to improve performance in a current job.
Mentoring is a process for developing employee talent over the long term. For
example, a more experienced individual—the mentor—serves as a teacher for an
employee in a current job and develops the employee for future jobs. Mentoring
relationships can be formal or informal. Formal mentoring is a mentoring arrangement
officially endorsed by the organization. Informal mentoring refers to a mentoring
arrangement that develops outside of official channels. For example, a senior
employee may begin informally mentoring a new employee on his own. Informal
arrangements tend to be more effective than formal ones. In an effective mentoring
relationship, the employee feels free to openly discuss job challenges and future plans
in a nonthreatening environment. As you might expect, the mentor is usually not the
employee’s immediate supervisor. When effective, mentoring helps an employee’s
career advancement and increases the employee’s commitment to the organization.
similar in some way to the evaluator. For example, employees who have the
same opinions or who have a lot in common with the evaluator receive higher
ratings than other employees.
Hiring-manager bias. An evaluator gives higher ratings to an employee she
directly hired. The evaluator may feel that the employee’s performance reflects
on her performance.
Halo effect. An evaluator tends to evaluate someone who is excellent in one
area of performance as excellent in all areas of evaluation. It also refers to the
tendency to give someone a poor evaluation across all areas because of one
unfavorable trait or behavior.
Negativity bias. An evaluator tends to pay more attention and give more
weight to negative than positive examples of an employee’s work. For example,
a manager might remember that an employee is frequently late for work but
doesn’t remember all the times he worked late.
The MBO approach to performance evaluation can combat many of these forms of
biases. Setting clear employee goals that are linked to measurable outcomes can help
avoid similarity error, hiring-manager bias, the halo effect, and negativity bias. Recency
error can be minimized by meeting regularly during the evaluation period with
employees and noting examples of good and bad performance during these meetings.
Although not appropriate for all positions, a 360-degree review can help avoid
bias. In a 360-degree review, opinions about an employee’s performance are solicited
from several sources, such as the employee, peers, subordinates, and customers.
When multiple ratings are combined, the overall results are much more likely to be
accurate. The downside to this approach is that it can be even more time-consuming
than MBO.
some areas.
When evaluators and employees talk openly and honestly about performance
expectations and results during the evaluation period and during the actual
evaluation, these types of bias can often be avoided.
Compensation
Compensation is the total monetary amount of benefits provided by an employer to
an employee in return for work performed as required. Compensation includes an
employee’s pay as well as the value of vacations, bonuses, insurance, and any other
employer-provided benefit, such as free parking or lunches. A compensation package
of pay and benefits is necessary to attract and retain the most qualified and talented
employees and to maintain or increase the level of employee performance. To develop
an attractive compensation package, insurance companies first determine what other
insurers and companies in other industries are providing to their employees.
Economic conditions also greatly affect the rewards a company can offer. For example,
a company is more likely to offer a more generous total compensation package in a
prosperous economy.
Because every employee is different, and expectancy theory suggests that rewards
must be important to an employee to be motivating, companies typically offer
employees options in compensation plans. Employee needs will vary based on age,
marital status, a spouse’s benefit status, and the number and age of dependents.
Figure 3.3 shows the top five overall benefit priorities from an employer and employee
perspective.
While employers and employees may be in agreement about the top benefit
priorities, the importance of other benefit offerings is less clear. A flexible benefits plan
is a benefit plan that allows each employee to select the benefits package that best
satisfies current needs. For example, a company may provide a set of core benefits
such as health insurance, life insurance, and vacation while allowing employees to
choose from among other benefits, such as paid parental leave or disability insurance.
Figure 3.4 illustrates what percentage of different age groups rank paid parental leave
or disability insurance as a top-five benefit.
For proper motivation, employees also need to be able to perceive that the
rewards a company provides are commensurate with the work done and are
administered fairly. To this end, companies link employee pay to performance through
a number of approaches, as shown in this chart.
Types of Compensation
Merit-based compensation ties employee pay to individual employee performance
in an effort to reward higher-performing employees with greater rewards. A merit-
based plan can only be as good as the performance appraisal system used to assess
performance. Any flaws in the performance appraisal system, such as rater bias, will
undermine the effectiveness of the merit-based system.
Performance-based compensation ties employee pay to a company-wide goal such
as profits or sales, or perhaps a nonfinancial goal such as improved customer
service levels. Companies sometimes use performance-based compensation in
conjunction with merit-based compensation so that a portion of an employee’s
compensation is merit-based and a portion is performance-based.
Skills-based pay may reward employees for developing and improving job skills. For
example, after attaining a certification or a specified level of proficiency, an
employee’s pay is automatically increased.
The amount of time and effort companies spend in developing and maintaining a
performance evaluation and compensation program is extensive. Developing
performance measurements that tie employee performance to merit-based
compensation is a lengthy process that requires determining skills and competencies
for jobs across an organization. Furthermore, even the best-developed evaluation and
compensation programs won’t be effective if managers are not trained to
communicate to each employee what superior performance looks like and the value of
the employees’ overall contribution to the organization. Nonetheless, studies of
motivation suggest that the best way for employers to motivate employees through
compensation is with a transparent and understandable program that links
compensation to performance.
According to the job characteristics model, the presence or lack of these five core
job dimensions can affect employee motivation in positive or negative ways. Research
has shown that not all workers desire or are motivated by all five characteristics. The
challenge for management is to match employees to jobs with suitable core job
dimensions. Millennials, in general, tend to value autonomy more than older baby
boomers. In addition, employees’ needs for various core job dimensions change
during a career. For example, a new employee who needs guidance is not motivated
by high levels of autonomy when starting a job. Note also that these features are not
necessarily objective. For example, our assembly-line worker found higher task
significance in her job once she realized the importance of her work to the car’s safety.
Thus, a manager might potentially increase the motivating aspects of routine jobs by
tying a job’s importance to a larger objective or mission that might not be evident to
the employee. For example, a claims representative might not understand the
importance of reviewing beneficiary signatures with the signatures on claims until the
manager explains how claim fraud negatively effects beneficiaries receiving their
benefits promptly and the company’s financial performance.
EXAMPLE
Answering calls from upset or irate customers is very stressful. Rotating
employees who handle these types of calls to other less stressful tasks for part of
the day helps minimize employee stress.
The job characteristics model describes five core job dimensions. A job
that requires the completion of a whole and identifiable piece of work
would rate high on the dimension of
A. Skill variety
B. Task identity
C. Task significance
Job enlargement is a job design technique often used when work tasks
are stressful.
A. True
B. False
Group Dynamics
Effective work groups outperform individuals because they include a greater diversity
of opinions, which typically results in higher-quality decisions. For this reason,
insurance operations utilize a variety of groups to accomplish work objectives. For
example, an insurer might form a task force or an ad hoc committee on a temporary
basis to solve an identified problem. Alternatively, in an effort to become more
customer-centric or decrease a product’s time-to-market, an insurer might create an
ongoing, cross-functional, self-directed work team that has the authority to make
decisions and perform certain activities. As a result, understanding how groups and
teams function in the workplace and how to motivate work group behavior is
important.
In general, people have a need for belonging that can be satisfied by participating
in groups. A group consists of two or more people who interact while sharing a
common identity and purpose. Informal groups are a collection of people who come
together primarily for friendship or social reasons. Formal groups are a collection of
people who come together to do productive work. Sometimes informal and formal
groups overlap in that coworkers may also be friends who socialize outside of work.
However, our focus is on formal groups and how to motivate and increase
effectiveness in work groups.
Cohesiveness
Cohesiveness is the degree to which group members work together to accomplish the
group’s purpose. More cohesive work groups are more effective and productive.
Certain group characteristics tend to increase the cohesiveness of the group, as
shown in Figure 3.5.
Size. Smaller groups are more cohesive than larger groups. The larger the
group, the less connected members are to each other and often to the group’s
purpose. However, a larger group may be necessary to gather functional
Group Development
Experts suggest that groups go through distinct stages of development.
Forming stage. Group members come together but are unsure about the
group’s purpose, structure, and leadership. At this stage, members are
cautious, avoiding conflict and controversy as they get to know each other and
begin the process of developing group norms. Norms are general standards of
behavior that dictate how people should behave in a given situation. Developing
an understanding of the group’s purpose and outlining general group rules are
important outcomes for this stage.
Storming stage. The next stage is marked by conflict as group members strive
to identify a leader and establish responsibilities. The more dominant group
members emerge as leaders. Other group members develop a general feel for
Organizational Values
An organization’s stated core values form the foundation for everything that takes
place in the workplace. When an organization’s values are not aligned with reward
systems and explicit work behaviors, employee morale and productivity suffer. In
extreme situations, companies may also be subject to financial or legal risk.
EXAMPLE
Misaligned Values and Work Behaviors
The Hankerville Manufacturing Company states that integrity is a core
organizational value. However, Melvin Thompson, who works in customer service,
is encouraged by his supervisor to handle customer problems with evasive
excuses rather than honesty and transparency. Mr. Thompson feels
uncomfortable engaging in these behaviors and views the Hankerville Company as
hypocritical for promoting integrity with words but not actions. Mr. Thompson is
currently looking for another job.
Employee Engagement
Employee engagement refers to an individual’s involvement with, satisfaction with,
and enthusiasm for the work she does. A highly engaged employee goes above and
beyond what a job requires on a regular basis. Organizations with higher-than-average
levels of employee engagement have higher levels of customer satisfaction, are more
productive, have higher profits, and experience lower turnover than do companies
with less engaged employees.
Research shows that employees are more engaged in their jobs when their own
values align with organizational values. For example, a person who is intellectually
curious and who values continual learning is highly engaged when his company sets a
high priority on employee development with continual learning and development
opportunities.
How can companies increase employee engagement? Asking current and former
employees about what a company is doing right is a good start.
EXAMPLES
Positive Statements
“I love my job because my manager cares about me as a person. She listens to me
and is always trying to help me grow and learn.”
“My coworkers are fantastic. They are all smart, hard-working people with diverse
backgrounds.”
Leaders can summarize positive statements into common values and create an
employee value proposition. An employee value proposition (EVP) is a formal statement
of what sets a company apart from other companies and identifies what employees
value most about working for the company. The EVP explains why employees would
want to join and stay with a company. Is it great coworkers, interesting work
assignments, wonderful leaders, or career opportunities?
An EVP allows a company to clarify what aspects of a job make employees happy
and then work on creating or improving those aspects in the larger work environment.
Common employee values include
A clear and compelling direction for the company
Open and honest communications among all levels of the company
Career growth and development opportunities
Appropriate pay and rewards
A balance between work and personal life
In tight job markets and with prospective job applicants increasingly using online
reviews to investigate prospective employers, investing in what makes employees
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Operational Excellence for Insurance Professionals Ch 3: Creating a Culture of Excellence | 3.44
happy makes good business sense. However, establishing organizational values that
incorporate employees’ common values makes even better sense. When a business
does good things for its employees because the company truly believes its employees
are its most valuable resource, the employees are more likely to be engaged in their
work and do good things for customers and the business.
EXAMPLE
Bystander Recognizing Harassment
Danny Channing overheard a male coworker telling a female coworker about his
date the night before. Danny knew this was not the first time Mark had cornered
Martha in such a way because she had mentioned to Danny that Mark’s behavior
made her uncomfortable. As the only female on their work team, Martha wanted
to be treated like one of the guys, but she felt uneasy sometimes with Mark’s
choice of topics. Danny quickly picked up an envelope on his desk and wrote their
manager’s name on the envelope. “Hey, Martha,” Danny said. “I’m expecting a call.
You mind running this over to Doug’s office for me?” Martha smiled thankfully at
Danny as she took the envelope and left. Once she was gone, Danny said casually
to Mark. “Hey, did you notice Martha seemed uncomfortable? Maybe the
workplace isn’t the best place to talk about such personal stuff.” Mark seemed
genuinely surprised and nodded in agreement.
criticism or how to listen to others can foster respect and promote teamwork.
Key Terms
corporate culture
leader
formal leadership
authority
informal leadership
trust
legitimate power
reward power
coercive power
expert power
referent power
positive reinforcement
negative reinforcement
punishment
extinction
continuous reinforcement
intermittent reinforcement
motivation
intrinsic motivation
extrinsic motivation
self-determination theory (SDT)
autonomous motivation
controlled motivation
expectancy theory
goal-setting theory
1. The following statement(s) can correctly be made about the corporate culture and the leadership
roles within organizations:
A. The corporate culture can promote or discourage certain behaviors in the workplace and directly
influence the success or failure of corporate strategies.
B. Generally, informal leadership refers to a person’s ability to influence the behavior of others
through the authority conveyed on the person by the company.
(1) Both A and B
(2) A only
(3) B only
(4) Neither A nor B
2. Trust refers to a belief in the integrity, character, or ability of others. Within this definition, ability
means that an individual
(1) acts in ways that are consistent with his beliefs
(2) cares about and supports other people
(3) possesses the technical skills or knowledge to get a job done
(4) possesses the force that gives purpose and direction to his behavior
Learning Objective: 3B. Describe the types of influence tactics leaders use in the workplace.
4. When Eric Sack wanted to persuade his manager to change a departmental policy, Mr. Sack used
ingratiating tactics in an attempt to influence his manager’s decision. This information indicates that
Mr. Sack most likely tried to influence his manager by
(1) targeting his manager’s emotions, values, or ideals
(2) presenting a detailed plan and logical information to convince the manager
(3) offering to complete extra work in return for his manager’s compliance with his request
(4) using flattery, praise, or humbling behavior
• • • • • •
Use the following information to answer questions 5 and 6.
Diane Chen is a contact center manager at the Magnolia Insurance Company. Consider the following
situations with regard to Ms. Chen’s use of behavior-modification strategies:
Situation 1—Ms. Chen praised an employee for making no errors in a given batch of
transactions.
Situation 2—Ms. Chen ignored an employee’s continuous complaining about the rudeness of
customers calling the company’s call center.
Learning Objective: 3C. Describe how individuals can modify their own behavior and that of
others by using the eight practices of effective leaders and managing antecedents and
consequences in the workplace.
6. With regard to the strategy of behavior modification Ms. Chen used in each situation and whether it
was used to encourage or discourage a behavior, it is correct to say that Ms. Chen used
(1) negative reinforcement in Situation 1 to encourage a specific behavior
(2) positive reinforcement in Situation 1 to discourage a specific behavior
(3) extinction in Situation 2 to discourage a specific behavior
(4) punishment in Situation 2 to discourage a specific behavior
• • • • • •
Learning Objective: 3D. Explain self-determination theory and expectancy theory and describe
the role of motivation in work performance.
7. Self-determination theory (SDT) is a motivation theory that describes the effects of intrinsic rewards
and extrinsic rewards. SDT also classifies motivation as autonomous motivation or controlled
motivation. According to SDT, autonomous motivation arises primarily from (intrinsic rewards /
extrinsic rewards). When autonomous motivation is involved, a person typically (is / is not) highly
motivated.
(1) intrinsic rewards / is
(2) intrinsic rewards / is not
(3) extrinsic rewards / is
(4) extrinsic rewards / is not
8. The following statements are about expectancy theory. Three statements are true, and one statement
is false. Select the answer choice containing the FALSE statement.
(1) Expectancy theory states that the strength of an individual’s tendency to act in a certain way
depends on the individual’s expectancy that the act will be followed by a given outcome.
(2) According to expectancy theory, an individual must believe that his effort will result in a
reward.
(3) According to expectancy theory, employees must have the skills and knowledge necessary for
performance.
(4) Expectancy theory states that the reward does not have to be important to the individual.
Learning Objective: 3E. Describe the performance evaluation process, its role in motivating
employees, and problems often encountered during performance evaluation.
9. The following statement(s) can correctly be made about the performance evaluation methods known
as a 360-degree review and management by objectives (MBO):
A. Although not appropriate for all positions, a 360-degree review can help avoid bias.
B. One advantage of a 360-degree review is that it significantly reduces the amount of time that
companies spend on performance evaluation.
C. One disadvantage of MBO is that supervisors meet with their employees only once per year—
when they communicate the results of the performance evaluation.
D. For MBO to be effective, goals must be specific and measurable so that employees know what
they must do.
(1) A, B, C, and D
(2) A and B only
(3) A and D only
(4) B and C only
(5) D only
10. Mentoring is a process for developing employee talent over the long term. Mentoring relationships
can be formal or informal. In general, (formal / informal) arrangements tend to be more effective. In
effective mentoring relationships, the mentor usually (is / is not) the employee’s immediate
supervisor.
(1) formal / is
(2) formal / is not
(3) informal / is
(4) informal / is not
11. Sandra Tiller, a manager, feels that punctuality is very important and considers punctual employees
to be efficient and hardworking. One of Ms. Tiller’s subordinates, Pam Senter, is at her desk on time
every morning and always arrives early for meetings. As a result, Ms. Tiller gave Ms. Senter an
excellent performance review, even though Ms. Senter’s performance was not excellent in some
other areas. Ms. Tiller’s tendency to think that Ms. Senter’s overall performance is excellent because
of her excellence in one area of evaluation demonstrates a cognitive bias known as
(1) recency error
(2) similarity error
(3) the halo effect
(4) the fundamental attribution error
Learning Objective: 3F. Identify different types of compensation and explain how companies link
performance evaluation to compensation systems to motivate employees.
12. The Azalea Company adopted a performance-based compensation system. Azalea’s primary goal in
designing this system most likely was to link employee compensation to
(1) each employee’s attainment of a specified level of proficiency in certain skills
(2) the amount of sales an employee makes
(3) the achievement of a company-wide goal such as profits or sales
(4) a specific example of an employee’s exceptional performance or accomplishment
Learning Objective: 3G. Describe the dimensions of a job and approaches to job design and work
arrangements that companies use to motivate employees.
13. For this question, select the answer choice containing the terms that correctly complete the blanks
labeled A and B in the paragraph below.
Researchers Hackman and Oldham proposed a job characteristics model that describes five core
dimensions of work: skill variety, task identity, task significance, autonomy, and feedback. The core
dimension known as A is the degree to which a job requires the completion of a whole and
identifiable piece of work. The core dimension known as B is the degree to which carrying
out job activities leads to direct and clear information about an employee’s performance.
A B
(1) skill variety task significance
(2) task identity feedback
(3) task significance autonomy
(4) autonomy task identity
14. The following statement(s) can correctly be made about job design and motivation:
A. Job rotation is appropriate for routine tasks in which shifting employees relieves the monotony of
doing one repetitive task.
B. Job enlargement typically results in jobs that have only one specialized task at which the
employee excels.
C. Job enrichment is the process of redesigning a job by decreasing workers’ control over how they
perform their work tasks.
(1) A, B, and C
(2) A and B only
(3) B and C only
(4) A only
Learning Objective: 3H. Describe workgroups, the characteristics of cohesive groups, and the
group development process.
15. Effectiveness and productivity is generally higher in cohesive groups. One way for a manager to
increase group cohesiveness is to
(1) give financial incentives based on individual performance rather than group performance
(2) increase the size of the group
(3) decrease the amount of time that group spends together
(4) set specific goals or directives for the group
16. Experts suggest that groups go through distinct stages of development: the forming stage, the
norming stage, the storming stage, the performing stage, and the adjourning stage. (Not all / All)
groups are able to move past the storming stage. In the (norming stage / storming stage), a group is
most subject to groupthink.
(1) Not all / norming stage
(2) Not all / storming stage
(3) All / norming stage
(4) All / storming stage
Learning Objective: 3I. Describe the benefits of employee engagement and how companies can
enhance employee engagement.
17. The following statement(s) can correctly be made about employee engagement:
A. Research shows that employees are more engaged in their jobs when their own values align with
organizational values.
B. An employee value proposition (EVP) allows a company to clarify what aspects of a job make
employees happy and then work on creating or improving those aspects.
(1) Both A and B
(2) A only
(3) B only
(4) Neither A nor B
Learning Objective: 3J. Explain the role of organizational values in encouraging trust, respect, and
openness in the workplace and ways that companies can discourage bullying and sexual
harassment.
18. The followings statements are about workplace bullying and sexual harassment. Three statements are
true, and one statement is false. Select the answer choice containing the FALSE statement.
(1) Taking credit for the work of others is not considered to be workplace bullying.
(2) Sexual harassment includes, but is not limited to, offensive gestures, joking, and language.
(3) Bystanders should try to diffuse an uncomfortable situation without drawing direct attention to
themselves.
(4) In situations where a bystander suspects something might have happened but is uncertain, the
bystander can talk to the victim privately.
Figure 1.2
Insurance Company Operations
A drawing of a column illustrates how certain insurance company operations
support other company operations. A list of primary insurance company
operations sits on top of the column and a list of insurance company support
operations are located on the column.
Primary operations on the top of the column are: (1) product development &
implementation, (2) sales & distribution, (3) underwriting, (4) policy issue & new
business, (5) policy administration, (6) customer service, (7) customer retention,
and (8) claims.
Support operations located on the column are: (1) marketing research, (2)
information technology, (3) human resources, (4) accounting/auditing, (4) internal
control, (5) other general administration.
Figure 1.3
Porter’s Model and Insurance
A picture of an arrow with three sections provides a simplified value chain model
for an insurance company’s operations. From top to bottom, the top section of
the arrow is resource inputs. Middle section is transformative processes. Bottom
section of the arrow is outputs. Each section provides several bulleted examples.
First section: Resource Inputs
Owner investments
Customer revenues
Employee labor and expertise
Data
Technology
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Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.3
Figure 1.4
Value Chain for Claims Processing
A picture of an arrow with three sections provides a simplified value chain model
for insurance claims operations. From top to bottom, the top section of the arrow
is resource inputs. Middle section is transformative processes. Bottom section of
the arrow is outputs. Each section provides several bulleted examples.
1. Resource Inputs
Employee labor
Data
Technology
2. Transformative Processes
Verify claims payable
Build customer satisfaction
Verify benefit amounts
Pay benefits to correct parties
3. Outputs
Benefit payments
Figure 1.5
Level of Concern about Insurance Industry
Disruption
A bar chart shows percentages that indicate the likelihood of disruption in the
insurance industry, banking and capital markets, and healthcare industry from
over-regulation, changing consumer behavior, technological change, and new
market entrants.
Figure 1.6
Artificial Intelligence System
A picture of a head has the term “Artificial Intelligence” in the middle. Five solid
lines come out from the head to identify capabilities of artificial intelligence
systems. Each line connects to a capability and a picture illustrating that
capability. Capabilities of artificial intelligence from left to right are: (1) recognizes
images with a picture of eyeglasses, (2) understands language with a picture of an
ear, (3) solves complex problems with a picture of a lightbulb, (4) creates
perspectives with a picture of a compass, and (5) learns and reasons with a
picture of a head processing information.
Figure 1.7
The Three-Box Solution
Three boxes are arranged around a three-pointed arrow to illustrate the
competing challenges insurers face innovating for the future while running a high-
performing business. First box is labeled “Present” and wording beside the box
says to “optimize current business.” Second box is labeled “Past” and wording
beside the box says to “forget the past.” Third box is labeled “Future” and wording
beside the box says to “create future.”
Figure 1.8
Workforce Demographics
A pie chart divides the 2017 U.S. Workforce by percentages into four demographic
categories: Boomers, Gen Xers, Millennials, and Others to illustrate that
Millennials are now the largest demographic group in the workforce.
Figure 2.1
Control Systems
A wooden road sign has three sections that identify three types of controls and
whether the control is best suited for controlling past operations, current
operations, or future operations. The top section of the road sign is an arrow
pointing to the left and is labeled
1. The Past – Feedback Controls
Examples of feedback controls include
Audits
Budgets
Exception reports
Performance appraisals
Quality reports
The middle section of the road sign is labeled
2. You are Here – Concurrent Controls
Examples of concurrent controls include
Budgets
Real-time exception reports
Real-time monitoring
Mentoring
The bottom section of the road sign is an arrow pointing to the right and is
labeled
3. The Future – Steering Controls
Examples of steering controls include
Budgets
Codes of Conduct
Job Descriptions
Policies and Procedures
Figure 2.2
Organizational Alignment Framework
A framework for creating and maintaining a strategically aligned company is
presented in five boxes that are aligned vertically on the left-hand side. An arrow
points downward from the first box connecting it to the second box, and so on
until reaching the fifth box.
The top box is labeled: Corporate Mission. To the right of this box are the
following questions:
Why does our company exist?
Who are our customers?
What do our customers want?
Who are our competitors?
What advantages do we have over our competitors?
The second box is labeled Corporate Strategies. To the right of this box are the
following questions:
How well do corporate strategies fulfill the corporate mission?
How do our corporate strategies take advantage of competitive advantages?
How might our corporate strategies adapt to new opportunities or perceived
threats?
How might corporate strategies affect employee satisfaction?
The third box is labeled: Resources. To the right of this box are the following
questions:
What financial, human, and technology resources are available to support the
delivery of corporate strategies?
How can management redeploy current resources for better support of
corporate strategies?
How can management obtain needed resources that are not available
internally?
How can management enhance employee satisfaction to better support
corporate strategies?
The fourth box is labeled: Business Processes. To the right of this box are the
following questions:
How well are processes supporting the accomplishment of corporate
strategies?
How do we measure success?
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Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.8
Figure 2.3
Strategic Alignment Matrix
A matrix with four sections illustrates that, at the best companies, purpose,
strategy, and capabilities align for effectiveness. The question “How aligned is your
long-term purpose?” is to the left of the matrix. The question “How aligned is your
strategy with your organizational capabilities?” is underneath the bottom of the
matrix.
The upper left quadrant of the matrix includes companies that have a long-
term purpose but do not have strategies or organizational capabilities aligned
with the purpose. These companies have the best of intentions but are
incapable of accomplishing those intentions.
The upper right quadrant includes companies that have a long-term purpose
that is aligned with strategies and organizational capabilities. Companies in
this quadrant have the very best chance of being successful.
The bottom left quadrant includes companies that do not have a long-term
purpose nor have they aligned strategy with organizational capabilities.
Companies in this quadrant are the least likely to survive.
The bottom right quadrant includes companies that have aligned strategy
with organizational capabilities but without a long-term purpose are going
nowhere.
Figure 2.4
Favorable Market Characteristics
A circle has the wording: “Favorable Markets Have…” in the middle of the page.
Arrows go out from this inner circle to connect with other circles identifying the
favorable market characteristics as follows:
Many potential customers
Few sellers
Low costs to acquire customers
Easy customer access
The possibility of repeat sales
Urgent need for a product
Easy product delivery
Few or no substitute products
Figure 2.5
Market Competition
The term “Monopoly” is centered over the picture of a one tall building with
characteristics in a bulleted list underneath as follows:
One seller or a small number of related sellers
Many barriers to entry
Advertising not important
Non-price competition not important
The term “Oligopoly” is centered over the picture of four tall buildings with
characteristics in a bulleted list underneath as follows:
Few sellers
Many barriers to entry
Advertising important
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Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.10
Video 2.1
The Management Cycle
Plan: Define Goals for the Future
Organize: Allocate Resources to Achieve Goals
Direct: Oversee Workers and Processes
Control: Ensure Results Align with Goals/Make Changes if Needed
Figure 3.1
Types of Power
The word “Power” is located in a circle with five boxes going around the circle.
Each box identifies a type of power with a brief description as follows:
Box 1. Legitimate Power: Results from superior position in the organizational
hierarchy
Box 2. Reward Power: Result from ability to allocate incentives based on
behaviors or performance
Box 3. Coercive Power: Results from ability to discipline others for poor
performance
Box 4: Expert Power: Results from skills, knowledge, or expertise
Box 5: Referent Power: Results from the loyalty, respect, or admiration of others
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.11
Figure 3.2
Intrinsic and Extrinsic Rewards
A box on the left-hand side has the word “Intrinsic Rewards” in it. Underneath the
box is an illustration of a head divided into two types of intrinsic rewards: sense of
accomplishment and self-esteem. On the right-hand side is a box with the word
“Extrinsic Rewards” in it. Underneath the box is an illustration of a head with
arrows pointing to the following extrinsic rewards located outside of the head:
money, praise, employee benefits, and promotions.
Figure 3.3
Top Five Benefit Priorities in 2018
A bar chart showing the top five overall benefit priorities from an employer and
employee perspective as follows:
Figure 3.4
Benefit Priorities by Age in 2018
A bar chart showing the value of paid parental leave and disability insurance to
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.12
Figure 3.5
Group Cohesiveness
An infographic to illustrate characteristics that can result in more or less cohesive
groups. A small blue circle in the middle is labeled “Group Cohesiveness.” Around
the blue circle is a light blue circle labeled “More Cohesive” that includes the
characteristics of cohesive groups: (1) small groups, (2) lots of group interaction,
(3) clear goals, and (4) groups rewards. Around the light blue circle is a green circle
that is labeled “Less Cohesive” that includes the characteristics of less cohesive
groups: (1) large groups, (2) no group interaction, (3) individual rewards, and (4)
no clear goals.
Video 3.1
Eight Practices of Effective Leaders
1. Effective leaders ask, “What needs to be done?”
[A man appears on screen.]
Man: Expanding internationally would really open new markets.
[A woman appears on screen.]
Woman: We don’t have the resources.
Man: Let’s see what we can do to free up the resources.
2. Effective leaders ask, “What is right for the company?
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Figure and Video Descriptions | DESC.13
Man: Personally, I’d like to expand internationally, but I guess it’s best to shore up
domestic operations first.
3. Effective leaders develop action plans based on top priorities.
[Man looks at a chart.]
Man: Hmmm. What should our first step be?
4. Effective leaders take responsibility for decisions
[Man talking to a group.]
Man: Senior management has developed a plan for domestic operations. I am
100% behind this plan.
5. Effective leaders communicate well with others.
[Man talking to woman.]
Man: Let’s plan on talking first thing every morning to make sure all of these
changes stay on track.
6. Effective leaders focus on opportunities rather than problems.
[Woman talking to man.]
Woman: Mid-west operations still have some issues.
Man: But I’m so excited that the west coast is doing better than anticipated.
7. Effective leaders run productive meetings.
[Man talking to woman.]
Man: Cancel the meeting. John can’t be there.
Woman: Right. It would be a waste of time without John.
8. Effective leaders think and say “we” rather than “I.”
[Man talking to a group.]
Man: We’ve come a long way since we started this initiative.
Video 3.2
Three Components of Expectancy Theory
1. Effort: Will effort result in performance?
Video 3.3
Remote Workers
Ina Allison, Ph.D.
Director, Assessment and Development Solutions
LOMA
A 2017 survey found that more than half of insurers across carrier types and size
reported positive realized benefits from enabling employees to work remotely.
Remote workers face unique challenges in that they do not have the same
resources available to them as in-office employees. For example, remote workers
may be required to trouble shoot their own technology problems. In addition,
remote workers can find it difficult to form supportive relationships with other
employees, and to collaborate on work projects. For these reasons, not every
person is a good fit for remote work. Remote workers need good organizational
skills, good communication skills, technological knowledge, and the ability to focus
in the presence of distractions in order to work successfully away from the office.
One of the most effective ways for employers to identify the people with the
needed skills, traits, and knowledge is to use validated assessment tools in the
hiring process. Assessment tests can help employers avoid hiring people who
would into be proficient at remote work because they require a great deal of
supervision or personal interaction. Assessment tests are also a great start in
determining the training needs of existing remote workers to improve their
productivity. Employers can incorporate low assessment scores into an
employee’s professional development plan. And, it’s not just remote workers who
need training and support. Managers must know how to keep remote workers
engaged, motivated, and accountable, and they may need assistance in
developing teleworking policies and procedures.
LOMA offers valid assessment tests including one that measures a person’s ability
to be successful in a virtual environment, focusing on the skills, preferences, and
attributes of people working remotely.
Endnotes
Chapter 1
1. “Intellectual Capital,” Investopedia, http://www.investopedia.com/ terms/ i/
intellectual_capital.asp#ixzz4tJvyzuEp (19 October 2017).
2. Kallenback and Sondergeld, “Disruption with a Capital ‘D.’”
3. “30-Year Treasury Rate: 39-Year Historical Chart,” Macrotrends,
http://www.macrotrends.net/2521/30-year-treasury-bond-rate-yield-chart (27
September 2017).
4. “Porter’s Value Chain, Understanding How Value Is Created Within Organizations,”
Mindtools, https://www.mindtools.com/ pages/ article/ newSTR_66.htm (8
September 2017).
5. Kay Rahardjo, “A Primer on Managing Operational Risk for Insurance Companies,”
Society of Actuaries 2014 Enterprise Risk Management Symposium, September 29–
October 1, 2014, Chicago, IL.
6. Jerry Miccolis, “Enterprise Risk Management in the Financial Services Industry: Still a
Long Way to Go,” International Risk Management Institute, https://www.irmi.com/
articles/ expert-commentary/ enterprise-risk-management-in-the-financial-services-
industry-still-a-long-way-to-go (13 September 2017).
7. Scott R. Kallenback and Eric Sondergeld, “Disruption with a Capital ‘D’” (Windsor, CT:
LL Global, Inc., © 2017). Used with permission; all rights reserved,
http://www.limra.com/ Research/ Abstracts/ PDF/ 2017/ 170825-04.pdf?
research_id=10737452562 (27 September 2017).
8. Ibid.
9. “By the Numbers: Fraud Statistics,” Coalition Against Insurance Fraud,
http://www.insurancefraud.org/ statistics.htm (25 September 2017).
10. Anthony Cilluffo and D’Vera Cohn, “10 Demographic Trends Shaping the U.S. and the
World in 2017,” Pew Research, http://www.pewresearch.org/ fact-tank/ 2017/ 04/ 27/
10-demographic-trends-shaping-the-u-s-and-the-world-in-2017/ (19 October 2017).
11. “Trending Topics: The Rise of the Blended Workforce,” CBS St. Louis, 3 March 2017,
http://stlouis.cbslocal.com/ 2017/ 03/ 03/ trending-topics-the-rise-of-the-blended-
Chapter 2
1. Joe D. Evans, “Symptoms of Corporate Strategy Misalignment,” Ezine, 26 April 2010,
http://ezinearticles.com/?Symptoms-of-Corporate-Strategy-
Misalignment&id=4138900 (13 November 2017).
2. Kevin Wilkins, “Trep Tip: Are You Netflix or Blockbuster? How a Clear Vision is Vital to
Innovation,” Silicon Bayou News, http://siliconbayounews.com/2016/03/29/trep-tip-
netflix-blockbuster-vision-vital-to-innovation/ (16 November 2017).
3. “Market Share,” Investopedia,
https://www.investopedia.com/terms/m/marketshare.asp (13 November 2017).
4. “Concentration Ratio,” Investopedia,
http://www.investopedia.com/terms/c/concentrationratio.asp#ixzz4xlxSUvpC(13
November 2017).
5. National Association of Insurance Commissioners, “NAIC Research and Actuarial
Department: Data at a Glance,” CIPR Newsletter, January 2014,
http://www.naic.org/cipr_newsletter_archive/vol10_data_glance.pdf (13 November
2017).
Chapter 3
1. Willis Towers Watson, “U.S. Employees Give Senior Leadership Low Marks, Willis
Towers Watson Research Reveals,” press release, 22 June 2017,
https://www.willistowerswatson.com/en/press/2017/06/us-employees-give-senior-
leadership-low-marks (8 December 2017).
2. J. Richard Hackman and Greg R. Oldham, Work Redesign (Reading, MA: Addison-
Wesley, 1980), 20.
3. Ron Clark, “Technology and the Workplace of Tomorrow,” Resource Magazine (June
2017): 14.
4. Bruce W. Tuckman and Mary Ann C. Jensen, “Stages of Small-Group Development
Revisited,” Group & Organizational Studies 2 (December 1977): 419–427.
5. Claire Cain Miller, “Sexual Harassment Training Doesn’t Work. But Some Things Do,”
New York Times, December 11, 2017,
https://www.nytimes.com/2017/12/11/upshot/sexual-harassment-workplace-
prevention-effective.html (17 January 2018).
Glossary
360-degree review
A performance evaluation process in which opinions about an employee’s
performance are solicited from several sources, such as the employee, peers,
subordinates, and customers and then combined into one rating.
80-20 principle
A specific guideline which states that 20% of the components of a situation
account for 80% of the outcomes.
activity
Any part of a set of actions that generates work to accomplish a job, problem, or
assignment.
activity analysis
A report that documents the expected tasks and estimated time for completing a
given activity, based on observation of or interviews with an individual performing
the activity.
ad hoc decision
An infrequent decision that can be made quickly at an individual level because the
risks involved is relatively small.
agile management
An approach to business effectiveness focused on finding and seizing
opportunities to improve operations and processes.
AI
— artificial intelligence.
analysis paralysis
The process of spending excessive time and energy in gathering decision-making
information.
analytical thinking
The breaking down of a problem into separate manageable parts, and finding the
best workable solution.
artificial intelligence
The area of computer science that emphasizes the development of intelligent
machines that work, learn, and react like humans.
attention bias
A consistent error in research outcomes that arises when people perform better
because they know they are being studied.
authentication requirements
Methods that enable companies to ensure that someone requesting or sending
information is who he or she claims to be.
authority
The right to direct others.
automation
The operation of a process, system, or piece of equipment without human
intervention.
autonomous motivation
Motivation arising primarily from intrinsic rewards affiliated with needs for
competence, relatedness, and autonomy.
balanced scorecard
A performance monitoring tool that displays a set of KPIs and compares the value
to performance standards.
bar chart
A graphical display of a frequency distribution.
barriers to entry
Obstacles, such as regulations, that impede a new seller’s entry into a market.
benchmark
A performance standard that a company aspires to achieve.
benchmarking
A formal program for measuring company performance results, identifying best
practices for the same performance areas, and emulating best practices for
company processes.
benchmarking study
A type of comparison study of expenses and other quantitative measures of
operational performance in which a company compares its performance with that
of its peers.
best payoff
In a payoff table, the highest possible value in each state of nature column.
big-bet decision
An infrequent, unfamiliar decision that can have a profound effect on a company’s
operations and future success.
big data
Large amounts of unprocessed information gathered from various sources, in
various formats, and at a rapid speed.
board of directors
group of individuals elected by the company’s owners that serves as the
company’s primary governing body.
BOD
See board of directors.
BPR
See business process reengineering. See Module 2, Chapter 4.
breakthrough innovation
A type of innovation that can change a company’s business model.
business case
A justification for a proposed project that highlights how a project’s benefits to the
company will outweigh its costs and risks.
business process
An ongoing method or system for responding to customer needs.
business strategies
Action plans for a line of business such as a product line, business unit, or
strategic business unit (SBU).
cascading report
An electronic report that brings together related data sets and offers distinctive
data views suitable for various user needs.
causal model
A forecasting model that uses historical data and other relevant variables as basis
for describing unknown future data points.
certainty
chat box
A computer system that uses artificial intelligence and spoken language or text to
answer the most commonly asked customer questions.
child report
A detailed report that supports the master or summary report.
cloud
A virtual storage system that maintains digital data on multiple connected servers
owned and managed by a hosting company.
coaching
A process in which a supervisor works with an employee to improve performance
on the job.
code of conduct
A formal statement of a company’s values and its expectations for how its
employees should behave in the course of business.
coercive power
Power that results from a person’s ability to punish others because of behaviors
or performance.
cognitive bias
A general term used to describe biases in the human mind that are difficult to
eliminate and that lead to inaccurate judgments.
cohesiveness
The degree to which group members work together to accomplish the group’s
purpose.
compensation
The total monetary amount of benefits provided by an employer to an employee in
return for work performed as required, which can include an employee’s pay as
well as the value of vacations, bonuses, insurance, and any other benefit provided
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Glossary | GLOSS.6
competitive advantage
Any aspect of a company—such as cost structure, distribution network, or
customer support—that allows the company to generate greater sales or retain
more customers than competitors
computational modeling
A form of modeling that uses the processing capabilities of IT to perform millions
of simulations at once.
concentration ratio
The sum of the percentage market shares of the top companies in the industry to
determine industry competitiveness.
concurrent controls
Organizational controls that continuously monitor a company’s activities and
systems as they are being performed to ensure that an activity is meeting
established performance standards.
confirmation bias
The human tendency to seek, interpret, and remember information that confirms
pre-existing beliefs.
conflict of interest
A situation that exists when the interests or actions of one entity, such as an
employee, are incompatible with the interests or actions of a related entity, such
as an employer.
consensus
An approach that requires all group members to understand and accept a
solution before jointly choosing the course of action.
continuous reinforcement
The process of either encouraging or discouraging every instance of a specific
behavior.
control chart
A chart showing a plot of data observations about a given process against a
measure of time.
controlled motivation
Motivation arising primarily from extrinsic rewards.
corporate culture
The attitudes, values, perceptions, beliefs, and experiences shared by a company’s
employees and instilled in new employees when they join the company.
corporate goals
The broad planning targets a company attempts to achieve in support of the
corporate mission. Also known as corporate objectives.
corporate governance
The responsibility and authority of a company’s board of directors to direct the
organization to fulfill its mission on behalf of the company’s stakeholders in a legal
and fiscally responsible manner.
corporate strategy
A long-term plan that a company intends to use to achieve its goal in the present
and future.
correlation
A measure of whether, and how strongly, two values are related.
crashing
A method for getting a project back on schedule by assigning additional resources
to the project, thereby increasing the cost of the project. See Module 2, Chapter 5.
critical path
The most time-consuming chain of events in a network model.
cross-cutting decision
A familiar decision that can have broad organizational impact and requires
effective collaboration among many different parts of an organization. See Module
3, Chapter 7.
cross-functional team
A group of representatives from two or more work groups that perform related
business activities across organizational boundaries.
cultural bias
A consistent cognitive error resulting from the tendency to interpret and report
data in terms of the observer’s own culture.
customer journey
The path each customer travels with a company from beginning to end, including
every interaction across every point of contact.
cybersecurity
All of the efforts a company takes to protect its computer systems and networks
from criminal activity.
data
Unprocessed facts.
data acquisition
The tasks involved in obtaining and storing information relevant to the business
question.
data analytics
The practice of applying analytical techniques to large amounts of raw data in
order to draw conclusions and make business decisions.
data architecture
The method or methods by which authorized users can access and apply the
information stored in company databases.
data editing
A process for detecting and correcting inconsistencies, errors, and omissions in a
collection of data.
data mining
A process in which an analyst examines numerical data to uncover trends and
patterns.
data visualization
The use of illustrative graphics to convey an intuitive understanding of data.
decision
A choice about a future action.
decision alternatives
The options a decision maker considers before selecting a future course of action.
decision constraints
Practical limitations that affect the selection of decision alternatives. See Module 3,
Chapter 8.
decision criteria
The simple-to-understand rules a decision maker uses to evaluate decision
alternatives.
decision environment
The collection of information, alternatives, values, and preferences available to a
decision maker at the time of a decision.
degree of confidence
The likelihood that a calculated value accurately predicts the true value. See
Module 3, Chapter 8.
delegated decision
A familiar and frequent low risk decision.
dependent activities
Activities that cannot be started until other activities have been completed
because the outputs from one activity are required inputs for another activity. See
Module 2, Chapter 5.
dependent variable
A variable that reacts to outside influences.
descriptive analytics
A type of data analytics that uses historical data to provide information about past
or current business conditions.
descriptive statistics
Statistics that summarize a population of data.
devils advocate
A person assigned to make a case against a decision-making team’s proposal. See
Module 3, Chapter 7.
diffusion
The process by which an innovation spreads outside of its place of origin. See
Module 3, Chapter 10.
disruptive change
A change that has the potential to influence how a business operates. See Module
3, Chapter 10.
DMADV
A five-step approach to solving a problem with the goal of creating a new business
process.
DMAIC
A five-step approach to solving a problem with the goal of improving an existing
business process.
drill-down option
A selection within a cascading report that enables linking from a parent report
down to a child report.
drill-through option
A link that the user of a summary report can click to see a different level of detail of
the information.
drill-up option
A selection within a cascading report that enables linking from a child report up to
a parent report.
earned value
A monetary value assigned incrementally to all project steps, with the project
earning another increment of monetary value as more work is completed. See
Module 2, Chapter 5.
effectiveness
In process management, completing the activities necessary to achieve the
desired outcome. Often referred to as "Getting the right things done." See Module
2, Chapter 4.
efficiency
In process management, completing an activity with minimal waste of human or
financial resources. Often referred to as "Getting things done right." See Module 2,
Chapter 4.
ego bias
A memory distortion that leads an individual or group to recall information in a
self-serving manner.
employee engagement
An individual’s involvement with, satisfaction with, and enthusiasm for the work he
does.
encryption
A method of securing information wherein a technology encodes collected data so
that only an authorized person possessing the required hardware and/or software
can decode that data.
enterprise-wide reporting
The use of knowledge management systems and information updates across
operations such that employees have access to information relevant to their roles.
EPMO
— enterprise project management office.
ERM
See enterprise risk management.
estimates
An approximate value that represents an unknown.
EVM
See earned value management. See Module 2, Chapter 5.
EVP
See employee value proposition.
exception report
A report generated automatically by a company’s systems when results deviate
from an established standard.
expectancy theory
A motivation theory stating that the strength of an individual’s tendency to act in a
certain way depends on the individual’s expectation that the act will be followed by
a given outcome, and by the attractiveness of that outcome to the individual.
expected time
An estimate of the time needed to complete project activities.
expert power
Power that results from a person’s skills, knowledge, or expertise.
extinction
The process of discouraging a specific behavior by ignoring it.
extranet
A limited-access network that allows people within an organization, and select
external stakeholders, to access company information
extrinsic motivation
A force that causes an individual to pursue an activity to obtain an external goal.
fast tracking
A method for reducing the time required to complete a project wherein a project
manager revisits the network’s critical path to decide if any sequential activities
can be performed simultaneously.
feasibility
The degree to which company resources will be able to carry a project to
completion.
feedback controls
Organizational controls that compare actual performance or output with
established standards at the end of a measurement period.
financial modeling
A computer-based mathematical model that approximates the operation of real-
world financial processes.
firewall
A system component designed to prevent unauthorized access to a network. See
Module 2, Chapter 4.
fishbone diagram
A graphical tool used for organizing potential causes for a problem and sorting the
causes into defined categories. Also called an Ishikawa diagram. See Module 2,
Chapter 6.
flextime
A work arrangement in which employees must work a certain number of hours per
week but have discretion in deciding when they will work.
float
The length of time an activity can be delayed without delaying the entire project.
Also known as slack time.
flow chart
A visualization method that shows the systematic progression of a series of
activities, using connecting lines and conventional symbols.
forecasting models
Mathematical constructs for projecting unknown or future outcomes using known
results or data.
formal leadership
The ability of a person to influence the behavior of others through the formal
authority conveyed on the person by the company.
frequency distribution
A set of data organized to show the number of times each outcome occurs. See
Module 3, Chapter 9.
Gantt chart
A graphical scheduling tool that separates projects into critical activities and plots
starting and ending dates for each activity.
gig economy
An environment in which an on-demand labor force is utilized to fill temporary or
short-term jobs, and there is no formal employer-employee relationship between
the independent worker and the employer.
global boundaries
Boundaries such as regulations or corporate strategy that are outside the control
of an innovation project.
goal-setting theory
A motivation theory stating that employees are motivated by challenging yet
attainable goals, along with appropriate feedback to mark progress toward goals.
group
Two or more people who interact while sharing a common identity and purpose.
groupthink
A phenomenon in which group members stress conformity and unanimity to the
point where alternate courses of action are ignored which results in inferior
decisions and group outcomes.
hacking
The process of using a computer and technology to gain unauthorized access to
another system’s data.
handoff
A transfer of work from one work team member to another, typically across
organizational boundaries.
heat map
A data map in which different values for a given variable appear as different colors.
heuristics
General rules that allow people to make decisions quickly without gathering
extensive information.
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Glossary | GLOSS.16
hindsight bias
The tendency of decision makers to believe, after a decision is implemented and a
certain result occurs, that they knew a decision would result in that outcome
during the decision-making process.
incremental innovation
A type of innovation that enhances operations and profitability.
independent activities
Activities that can progress concurrently with no change to resource needs. See
Module 2, Chapter 5.
independent variable
A variable that influences the behavior of another variable.
inferential statistics
Statistics that allow a decision maker to draw conclusions about a large population
based on the sample group.
infographic
A graphic representation designed to make information easy to understand and
patterns easy to identify.
informal leadership
The ability to influence the behavior of others by means other than the formal
authority conferred on the person by the organization.
information
A collection of data that is converted into a form that is meaningful or useful for
the accomplishment of some objective.
information technology
The use of computer systems to gather, record, manage, analyze, and transmit
company information.
organization’s mission, vision, strategies, and resources. See Module 3, Chapter 10.
innovative thinking
The process of solving problems by discovering, combining, and arranging
insights, ideas, and methods in new ways.
intellectual capital
The sum of all employee knowledge that a company can use to drive profits as well
as other proprietary information that a company owns.
intermittent reinforcement
The process of encouraging or discouraging some, rather than all, instances of a
specific behavior.
intranet
A private network accessible only to people within an organization. See Module 2,
Chapter 4.
intrinsic motivation
A force that causes an individual to initiate an activity for its own sake, because the
activity is satisfying to the individual.
ISO 9000
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Glossary | GLOSS.18
IT
— information technology.
job description
A description of the duties, responsibilities, and accountabilities for a job.
job design
The way in which the elements of a job are organized.
job enlargement
An approach to job design in which a new job is created by combining two or more
specialized tasks to add more variety.
job enrichment
An approach to job design in which a job is redesigned to allow workers more
control over how they perform their work tasks.
job rotation
An approach to job design in which emloyees are periodically shifted from one
task to another task with similar skill requirements.
job sharing
A work arrangement that allows two or more individuals to split one job.
kaizen
A gradual and continuous approach to process improvement using a series of
modest changes and feedback from process team members.
key process
knowledge workers
Employees who can interpret information within a specific, yet broad, domain; use
skills and knowledge to define problems; and identify alternative solutions to
problems.
KPI
See key performance indicator.
leader
A person who influences other people toward the achievement of a vision or set of
goals.
lean management
A continuous process improvement approach that emphasizes creating a value
stream of Lean processes with minimal waste.
legacy systems
Older computer systems or applications that perform essential functions and are
costly to replace or redesign.
legitimate power
Power that occurs solely because of a person’s superior position over others in
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Glossary | GLOSS.20
line diagram
A diagram used to show changes in data over time.
machine learning
A component of artificial intelligence that allows computers to identify patterns
within data without express instruction about where or how to find them.
machine learning
A component of artificial intelligence that allows computers to identify patterns
without being expressly told where or how to find them.
management by exception
A performance management technique requiring that a manager investigate
performance that falls outside an established, acceptable performance range.
management by objectives
A performance evaluation technique in which the employee and supervisor work
together to (1) set clear and attainable goals for the appraisal period and (2)
develop a plan for achieving those goals.
margin of error
A measure that indicates the likely range of inaccuracy of a given sample result
relative to a result based on the total population
market
A physical or virtual area in which buyers and sellers of a particular good or service
interact to exchange resources.
marketing innovation
The introduction of a new or significantly improved marketing method, product
design, product packaging, product placement, product promotion, or product
pricing structure.
market leadership
A company’s competitive position relative to its competitors in terms of market
share percentage.
market share
The percentage of an industry or market’s total sales that is earned by a particular
company over a specified time period.
MBO
See management by objectives.
mean
A measure of central tendency that identifies the numerical average of a series of
values.
measurement bias
A systematic error arising from the instruments used for data collection. See
Module 3, Chapter 8.
measures of dispersion
Representative values that describe the distribution of data around specified
central values.
median
A measure of central tendency that identifies the middle value in a set of values
arranged in numerical order.
mentoring
A process for developing employee talent over the long term.
merit-based compensation
A compensation plan that ties employee pay to individual employee performance
in an effort to reward higher performing employees with greater rewards.
milestone
An important interim goal for a project.
milestone schedule
A summary listing of major activities and key milestones. Sometimes referred to as
a master schedule.
mission statement
A statement of a company’s fundamental purpose or reason for existence.
mode
A measure of central tendency that identifies the value that appears most often in
a population.
model
An item or system that simulates something else.
monopolistic competition
A market with many sellers, similar products and services, a customer perception
of non-price differences between products and services, insignificant barriers to
entry for new sellers, and reliance on advertising.
monopoly
A market in which one firm, or a group of firms acting together, controls the
production and distribution of a product.
mortality study
A study of the longevity and ages at death of large groups of people See Module 3,
Chapter 9.
mortality tables
A visual tool that presents the number of deaths projected to occur within a given
motivation
The force that gives purpose and direction to an individual’s behavior and can be
classified as either intrinsic or extrinsic.
negative reinforcement
The process of encouraging a specific behavior by immediately withdrawing or
terminating something that an individual finds unpleasant or negative.
network model
A visual representation of the activities in a process or project used to identify the
best use of resources. Sometimes referred to as a program evaluation and review
technique (PERT) network.
network path
A sequence of network activities from project inception to project end. See Module
2, Chapter 5.
NIGO rate
A measure of the percentage share of all incoming paperwork received with
incomplete documentation.
nonmedical underwriting
A process in which examination-based proof of medical insurability is not required
from a proposed insured.
nonrandom sampling
A sampling method that bases sample selection on specific, personally selected
criteria.
nonresponse bias
A type of sampling bias that occurs when some members of a sample are
inherently more likely to provide information than other members of that same
Copyright © 2019 LL Global, Inc. All rights reserved. www.loma.org
Operational Excellence for Insurance Professionals Glossary | GLOSS.24
sample.
non-value-adding activity
Any activity that does not make the product or service more valuable to the
customer.
norms
The general standards of behavior that dictate how people should behave in a
given situation.
oligopoly
A market with few sellers, undifferentiated products or services, vigorous
advertising, and significant barriers to entry for new sellers.
operational risk
The potential for financial losses resulting from inadequate or failed processes
and controls, people, or systems.
operational strategy
A general action plan for activities that must occur within a budget dictated by the
company’s corporate plan.
operations
The activities any company undertakes to produce goods and services.
operations management
Managerial efforts to ensure that the products and services a company provides
to customers meet stated quality standards, are timely, and are delivered
profitably at the lowest reasonable cost to the company.
opportunity cost
A benefit that the decision maker forfeits or gives up in choosing one alternative
over another.
optimism bias
A tendency for innovators to form unrealistically positive expectations as to future
outcomes and to codify these expectations into plans and performance standards.
optimistic time
The shortest amount of time a given activity is likely to require. See Module 2,
Chapter 5.
organizational agility
An organization’s ability to adapt quickly to changes in the external environment.
organizational innovation
The introduction of a new or significantly improved organizational design in
business practices or workplace organization.
org chart
A hierarchically patterned array of boxes and lines depicting the formal lines of
authority, responsibility, and communication in an organization. See Module 2,
Chapter 5.
outlier
An extremely high or low value that is not representative of the other values in a
dataset.
parent report
A master or summary report.
Pareto chart
A bar chart that depicts how much each factor contributes to a specified defect,
with all sources arranged in descending order from left to right. See Module 2,
Chapter 6.
Pareto principle
A guideline which states that a small percentage of causes contributes to a large
percentage of the results.
payoff
The projected value of an outcome from a decision.
payoff analysis
A formal approach to decision making wherein each combination of a decision
alternative and a state of nature result in a potential payoff.
payoff table
A decision analysis tool that summarizes potential outcomes from a decision in a
tabular format.
PDCA cycle
See Plan-Do-Check-Act cycle. See Module 2, Chapter 6.
performance-based compensation
A compensation plan that ties employee pay to a company-wide goal such as
profits or sales, or perhaps a nonfinancial goal such as improved customer service
levels.
performance dashboard
A type of software that graphically displays the status of a company’s most
important performance measures.
performance standard
An established level of performance to which a company or an individual
compares actual performance.
pessimistic time
The longest amount of the a given activity is likely to require. See Module 2,
Chapter 5.
pie chart
A graphical display that presents data in the shape of a circle divided into radial
sections.
Plan-Do-Check-Act cycle
A four-step control cycle technique for supporting quality improvement. See
Module 2, Chapter 6.
PMI
— Project Management Institute.
PMO
See project management office. See Module 2, Chapter 5.
point estimate
An estimated result that is assigned a single value.
political bias
The tendency for innovators to turn a project into a competition and to try to
outdo one another in order to win.
population
A set of all items that share a specified characteristic.
positive reinforcement
The process of encouraging a specific behavior by immediately following it with a
consequence that the individual finds pleasing or positive.
PPM
See project portfolio management. See Module 2, Chapter 5.
predictive analytics
An analytical technique used to predict future events or customer behaviors and
anticipate conditions that are likely to cause negative consequences. See Module
3, Chapter 9.
prescriptive analytics
A type of proactive data analytics that uses data to suggest decision alternatives
and show the possible implications of each decision. See Module 3, Chapter 9.
prevention costs
Expenses for proactively limiting operational defects.
procedure
process
A series of ongoing operations, work activities, or tasks ordered in a definite
sequence and directed toward achieving an end-result.
process analysis
A systemic evaluation of all aspects of a process to make the process faster, more
efficient, less expensive, and more focused on the customer. See Module 2,
Chapter 4.
process charter
A formal document that establishes the authority and accountability of a process
team.
process innovation
The introduction of a new or significantly improved production process or method
of delivery, including changes in techniques, equipment, or software. See Module
3, Chapter 10.
process management
A formal method of defining, documenting, evaluating, and improvement
resources and workflow so that processes better achieve the tasks they were
designed to accomplish.
process map
A graphical representation of a business process, typically using a recognized set
of graphical symbols.
product innovation
The introduction of a new product that is significantly different from existing
products in terms of its characteristics, materials, components, software,
functions, or intended uses.
project
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Operational Excellence for Insurance Professionals Glossary | GLOSS.29
project baseline
A measurable starting point agreed upon by various stakeholders as performance
standards for a project.
project change
An acknowledged deviation from the original project plan.
project charter
A document that formally authorizes the project to take place and appoints a
project manager.
project constraints
Circumstances that place limitations on a project, and traditionally include scope,
time, and cost.
project deliverable
A measurable outcome from a project.
project lifecycle
The combination of all project phases, from project initiation to project closure.
project management
A framework for directing projects to completion that involves (1) setting project
goals, and (2) planning, monitoring, and controlling project tasks, resources, and
costs to meet those goals.
project manager
The person who oversees the project team.
project phase
A segment of the project lifecycle consisting of a set of related project activities.
project plan
A comprehensive, formally executed document used to guide a project through
closure.
project schedule
A document that shows links between project elements, identifies dependencies,
and shows a sequence that satisfies time and other constraints.
project sponsor
Typically a company executive, the person who authorizes the project, provides
support and resources to the project, and communications project information up
the organizational chain of command.
project status
The project’s progress toward completion at a given point in time. See Module 2,
Chapter 5.
project team
The group of team members assigned to perform any portion of the project
activities.
punishment
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Operational Excellence for Insurance Professionals Glossary | GLOSS.31
QC
— quality circle.
qualitative research
Research that uses subjective data collection methods and produces data that is
difficult to summarize in numerical form.
quality analysis
Any type of research or investigation to understand an aspect of preventing
defects or meeting customer needs.
quality assurance
The activities a company undertakes to make certain the company delivers
satisfactory performance to customers.
quality circle
A problem-solving group of 5 to 10 employees who meet regularly to discuss
quality improvement, suggest ways to reduce costs, and present
recommendations to higher management.
quality management
The activities an organization conducts on an ongoing basis to plan, control,
measure, and improve its performance to ensure that its products or services
consistently meet or exceed customer expectations. Also called performance
management.
quantitative research
Research designed to generate easy-to-analyze numerical data.
random sampling
A technique in which each item of a population has a determinable chance, or
probability, of selection.
range
A measure of dispersion equal to the difference between the highest and lowest
values in a particular population.
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Operational Excellence for Insurance Professionals Glossary | GLOSS.32
range estimate
A result that includes possible values within specified limits.
RCA
— root-cause analysis.
referent power
Power that exists when a person can influence the behavior of others because of
others’ loyalty, respect, admiration, or a desire for that person’s approval.
response bias
A type of sampling bias that occurs when the way researchers word a question
distorts the answer.
reward power
Power that arises from a person’s ability to allocate incentives to others based on
behaviors or performance.
rework costs
The costs of correcting defective work.
role
A socially determined way of behaving in a specific situation.
root-cause analysis
A set of problem-solving methods and tools designed to determine the actual
causal factors that led to a particular incident or result.
rules engine
A software-based repository of key business process rules that can be consistently
applied in specified circumstances to produce the desired results.
salary survey
A type of comparison study in which employers share their compensation data
with an external researcher, who accumulates, analyzes, and presents the data to
study participants.
sales commission
sampling
A statistical technique used to examine a portion of a given group in order to
develop conclusions about the entire group.
sampling bias
An error in choosing participants that occurs when the method used to obtain
information from a sample results in a sample that is not representative of the
population being studied.
scatter diagram
A diagram used to check visually for a likely correlation between two variables.
schedule variance
The difference between the scheduled finish date for an activity and the actual
finish date.
scope creep
The practice of gradually modifying features of a project and its objectives without
formally addressing and negotiating changes with project stakeholders. Scope
creep can make it difficult to successfully complete a project as planned.
scope statement
A report that clearly states the limits on a project by specifying the project size,
resources, limitations, and deliverables.
scrum
A framework for managing the processes involved in software development. See
Module 2, Chapter 4.
scrum master
A person who facilitates a scrum team by managing all of the business processes
required for software development.
SDT
See self-determination theory.
security token
A device used to generate a one-time-use code the user enters in order to gain
access to private company information.
selection bias
A type of sampling bias that occurs when the method of data collection
systematically excludes certain members of the sample.
self-determination theory
A motivation theory that proposes people have three basic psychological needs
for competence, relatedness, and autonomy.
semi-structured data
A type of data that includes a combination of structured and unstructured
elements.
sexual harassment
Any unwelcome sexual attention or conduct that creates an offensive or
intimidating work environment.
silo
Operational unit that operates in isolation from other operating units, not
understanding how their jobs relate to other operational units or how corporate
goals relate to their jobs.
simplicity bias
The tendency to believe that a complex outcome must have come from a complex
cause, and a complex outcome cannot have come from a simple cause. See
Module 3, Chapter 10.
Six Sigma
A disciplined approach for defining, measuring, analyzing, improving, and
controlling quality by reducing process defects so that results fall within
established parameters.
size bias
A tendency to prefer large concepts instead of smaller ones.
skills-based pay
A compensation plan that rewards employees for developing and improving job
skills.
specific boundaries
Boundaries that relate directly to an innovation project, such as the budget, time
available, or resources needed.
speech analytics
A descriptive analytics technique used to gain insight into customers’ attitudes
about a company by analyzing recorded speech.
spot bonus
A payment made to an employee immediately after the employee performs in an
exceptional way on the job or achieves a level of proficiency.
stakeholder
Any party that has an interest in how a company conducts its business.
standard deviation
standing committee
A permanent committee that company executives use as a continuing source of
advice.
stand-up meeting
A meeting during which employees stand up as they offer summaries about their
progress on an activity. The unintuitive feature of standing is intended to keep
meetings short. In some cases, these status checks don’t require standing or are
conducted virtually and still retain the name "stand-up meeting."
states of nature
Influences on the outcome of a decision that are not under the decision maker’s
control.
statistical analysis
The use of mathematical techniques for collecting, organizing, describing,
analyzing, and interpreting numerical data to support decisions.
statistical bias
A consistent or systemic error arising from a flaw in the research design. See
Module 3, Chapter 8.
statistical validity
The degree to which an observed result can be relied upon and not attributed to
random error in sampling or measurement.
steering committee
A group of stakeholders with diverse company backgrounds who guide and
oversee the planning and implementation of a project.
steering controls
Organizational controls that proactively communicate expectations and try to
prevent problems from occurring.
stoplight indicators
Red, yellow (or amber), green, and sometimes blue symbols that indicate how
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Operational Excellence for Insurance Professionals Glossary | GLOSS.37
STP
See straight-through processing. See Module 2, Chapter 4.
straight-through processing
A fully automated process in which the steps in a specified transaction type are
conducted without human intervention.
structured data
A type of data that exists in a fixed field within a record, data file, or spreadsheet;
allows for systemic organization; and is easy to enter, store, and analyze.
substitute products
Two or more products that customers can use to satisfy the same wants or needs.
table
An orderly listing of data.
tactic
An action designed to support an operating strategy.
tasks
The smallest units in a process to undergo analysis.
telecommuting
A work arrangement in which employees work remotely away from the office.
ISO
— International Organization for Standardization.
A forecasting model that uses the data value(s) for the most recent period as the
forecast value(s) for the next future period.
time-series data
Information about a variable over successive periods.
time-series model
Forecast models that estimate unknown future values based on known, historical
data.
TQM
— total quality management.
transactional work
Routine and repetitive tasks with little flexibility in how processes are completed.
trend analysis
A technique that involves forecasting the future movement of specified factors
based on observed historical patterns of change.
trust
A belief in the integrity, character, or ability of others.
unstructured data
A type of data that does not have a rigid pattern and can’t be organized
systematically.
value-adding activity
Any activity that makes a product or service more valuable to the customer. See
Module 2, Chapter 4.
value chain
A set of activities that a company carries out to create stakeholder value.
value stream
The continuous flow process of value creation.
variable
An item of data with a value that changes over time.
variance
A measure of dispersion calculated as the average squared distance between the
population mean and each individual item in a population.
variation
Changes from the norm that do not indicate a pattern of behavior. See Module 3,
Chapter 9.
vision statement
A statement of where a company would like to be in the future.
WBS
See work breakdown structure. . See Module 2, Chapter 5.
A forecasting model that assigns relative weights to data values used in a forecast
and finds the average of the values.
workplace bullying
The tendency of individuals or groups to covertly or overtly use aggressive or
unreasonable behavior against a coworker or subordinate that is threatening,
humiliating, or intimidating.
Chapter 2
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Chapter 3
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