SAS Business Intelligence & Reporting Module — Software Requirements Specification (SRS)
Table of Contents
- 1 Document Information
- 2 Project Overview
- 3 User Requirements
- 3.1 Executive Dashboards
- 3.2 Operational Reports
- 3.3 Financial Analytics
- 3.4 Claims Analytics
- 3.5 Membership Analytics
- 3.6 Sales Analytics
- 3.7 Utilization Analytics
- 3.8 Provider Analytics
- 3.9 Wellness Analytics
- 3.10 Custom Report Builder
- 3.11 Scheduled Reports
- 3.12 Data Exports
- 3.13 Regulatory Reporting
- 3.14 Adhoc Querying
- 3.15 Report Management
- 4 Detailed Feature Requirements
- 4.1 Ft Rpt Exec Kpi Dashboard
- 4.2 Ft Rpt Exec Financial Summary
- 4.3 Ft Rpt Exec Claims Overview
- 4.4 Ft Rpt Exec Membership Trends
- 4.5 Ft Rpt Exec Drilldown
- 4.6 Ft Rpt Ops Claims Detail
- 4.7 Ft Rpt Ops Membership Detail
- 4.8 Ft Rpt Ops Financial Detail
- 4.9 Ft Rpt Ops Sales Detail
- 4.10 Ft Rpt Ops Provider Detail
- 4.11 Ft Rpt Ops Wellness Detail
- 4.12 Ft Rpt Fin Revenue Analysis
- 4.13 Ft Rpt Fin Loss Ratio
- 4.14 Ft Rpt Fin Expense Analysis
- 4.15 Ft Rpt Fin Profitability
- 4.16 Ft Rpt Fin Cashflow
- 4.17 Ft Rpt Clm Frequency Severity
- 4.18 Ft Rpt Clm Category Analysis
- 4.19 Ft Rpt Clm Provider Analysis
- 4.20 Ft Rpt Clm Fraud Indicators
- 4.21 Ft Rpt Clm Tat Analysis
- 4.22 Ft Rpt Mbr Enrollment Trends
- 4.23 Ft Rpt Mbr Retention Analysis
- 4.24 Ft Rpt Mbr Demographics
- 4.25 Ft Rpt Mbr Lifetime Value
- 4.26 Ft Rpt Mbr Utilization
- 4.27 Ft Rpt Sls Agent Performance
- 4.28 Ft Rpt Sls Channel Analysis
- 4.29 Ft Rpt Sls Product Mix
- 4.30 Ft Rpt Sls Pipeline
- 4.31 Ft Rpt Utl Service Utilization
- 4.32 Ft Rpt Utl Provider Patterns
- 4.33 Ft Rpt Utl Cost Efficiency
- 4.34 Ft Rpt Prv Performance
- 4.35 Ft Rpt Prv Cost Analysis
- 4.36 Ft Rpt Prv Network Coverage
- 4.37 Ft Rpt Well Participation
- 4.38 Ft Rpt Well Outcomes
- 4.39 Ft Rpt Well Roi
- 4.40 Ft Rpt Custom Builder
- 4.41 Ft Rpt Custom Save Share
- 4.42 Ft Rpt Custom Visualizations
- 4.43 Ft Rpt Custom Calculations
- 4.44 Ft Rpt Schedule Config
- 4.45 Ft Rpt Schedule Distribution
- 4.46 Ft Rpt Schedule History
- 4.47 Ft Rpt Export Excel
- 4.48 Ft Rpt Export Pdf
- 4.49 Ft Rpt Export Csv
- 4.50 Ft Rpt Export Json
- 4.51 Ft Rpt Reg Tira Returns
- 4.52 Ft Rpt Reg Tax Returns
- 4.53 Ft Rpt Reg Statutory Accounts
- 4.54 Ft Rpt Reg Compliance
- 4.55 Ft Rpt Adhoc Query Builder
- 4.56 Ft Rpt Adhoc Quick Filters
- 4.57 Ft Rpt Adhoc Data Preview
- 4.58 Ft Rpt Mgmt Catalog
- 4.59 Ft Rpt Mgmt Access Control
- 4.60 Ft Rpt Mgmt Audit Trail
- 4.61 Ft Rpt Mgmt Versioning
1 Document Information
| Field | Value |
|---|---|
| Project Name | SAS Business Intelligence & Reporting Module |
| Version | 1.0 |
| Date Created | 2025-10-17 |
| Date Modified | 2025-10-17 |
| Document Type | Software Requirements Specification |
| Module Code | REPORTING |
| Prepared By | Sky Software Engineering Team |
| Status | Draft |
2 Project Overview
2.1 Description
The Business Intelligence & Reporting module provides comprehensive analytics, reporting, and data visualization capabilities across all SAS modules. It includes executive dashboards for C-level decision making, operational reports for day-to-day management, advanced analytics for claims/membership/financial/provider/wellness data, custom report builder for ad-hoc analysis, scheduled report distribution, data exports, regulatory reporting, and real-time KPI monitoring. The module integrates with all operational modules to provide unified reporting and supports multi-dimensional analysis, drill-down capabilities, data export in multiple formats, and role-based access to reports and dashboards.
2.2 Objectives
- Provide real-time executive dashboards for strategic decision making
- Enable operational reporting across all modules (claims, membership, finance, sales, provider, wellness)
- Support advanced analytics with drill-down, filtering, and multi-dimensional analysis
- Offer custom report builder for business users to create ad-hoc reports
- Automate scheduled report generation and distribution
- Enable data exports in multiple formats (Excel, PDF, CSV, JSON)
- Support regulatory reporting requirements (TIRA, tax authorities)
- Provide real-time KPI monitoring and alerts
- Enable self-service BI for authorized users
- Maintain audit trail for all report access and generation
2.3 Scope
2.3.1 In Scope
- Executive dashboards (KPIs, trends, performance metrics)
- Operational reports (claims, membership, finance, sales, provider, wellness)
- Financial analytics (revenue, expenses, profitability, loss ratios)
- Claims analytics (frequency, severity, patterns, fraud indicators)
- Membership analytics (enrollment, retention, demographics, lifetime value)
- Sales & agent performance reports
- Utilization analysis (medical services, provider patterns)
- Provider analytics (performance, cost efficiency, quality metrics)
- Wellness program metrics and ROI analysis
- Custom report builder with drag-and-drop interface
- Scheduled reports with automated distribution
- Data exports (Excel, PDF, CSV, JSON)
- Regulatory reporting (TIRA, tax, statutory returns)
- Ad-hoc querying and analysis
- Report versioning and audit trail
- Role-based access control for reports
2.3.2 Out Of Scope
- External BI tool integrations (Power BI, Tableau) - covered in Infrastructure module
- Data warehouse ETL processes - covered in Infrastructure module
- Machine learning and predictive analytics - future enhancement
- Real-time streaming analytics - future enhancement
2.4 Technology Stack
2.4.1 Backend
Django REST Framework, PostgreSQL, Redis (caching), Celery (scheduled reports)
2.4.2 Frontend
React 19 (web dashboards), Chart.js/D3.js (visualizations)
2.4.3 Reporting Engine
Custom report builder + PDF generation (WeasyPrint/ReportLab)
2.4.4 Data Export
openpyxl (Excel), pandas (CSV), JSON serializers
2.4.5 Database
PostgreSQL with materialized views for performance
2.5 Key Stakeholders
- Executive Management (CEO, CFO, COO)
- Finance Team (financial reports, revenue analysis)
- Claims Team (claims analytics, fraud detection)
- Underwriting Team (risk assessment, pricing analytics)
- Sales Management (agent performance, conversion rates)
- Provider Network Team (provider performance, utilization)
- Wellness Team (program metrics, ROI analysis)
- Compliance Team (regulatory reporting)
- IT/BI Team (report administration, custom reports)
3 User Requirements
3.1 Executive Dashboards
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-EXEC-KPI-DASHBOARD | view executive KPI dashboard with real-time metrics | monitor overall business performance at a glance | Must Have | Key metrics: total members, premium revenue, claims ratio, net profit, new policies, retention rate, average claim cost, customer satisfaction. Real-time updates, trend indicators (up/down arrows), comparison to targets. |
| FT-RPT-EXEC-FINANCIAL-SUMMARY | view financial performance summary dashboard | track revenue, expenses, profitability trends | Must Have | Revenue breakdown by product/region, expense analysis, profit margin trends, loss ratio by product, combined ratio, cash flow summary. Monthly/quarterly/yearly views. |
| FT-RPT-EXEC-CLAIMS-OVERVIEW | view claims performance overview dashboard | monitor claims trends and identify issues | Must Have | Claims submitted vs settled, average TAT, claims ratio, fraud alerts, high-value claims, claims by category/provider, pending claims backlog. |
| FT-RPT-EXEC-MEMBERSHIP-TRENDS | view membership growth and retention dashboard | track enrollment trends and member lifecycle | Must Have | Total members by product/region, new enrollments, terminations, retention rate, churn analysis, member demographics, lifetime value trends. |
| FT-RPT-EXEC-DRILLDOWN | drill down from executive dashboard to detailed reports | investigate specific metrics and trends | Must Have | Click on any metric to drill down to underlying data, filter by date range/product/region, export drill-down results, maintain context during navigation. |
3.2 Operational Reports
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-OPS-CLAIMS-DETAIL | generate detailed claims reports | analyze claims by various dimensions | Must Have | Filter by date range, product, provider, claim type, status, amount range. Group by product/provider/diagnosis/member. Export to Excel/PDF/CSV. |
| FT-RPT-OPS-MEMBERSHIP-DETAIL | generate detailed membership reports | analyze member demographics and status | Must Have | Active/inactive members, enrollments/terminations by period, member demographics (age, gender, location), policy details, dependent analysis. |
| FT-RPT-OPS-FINANCIAL-DETAIL | generate detailed financial reports | analyze revenue, expenses, and profitability | Must Have | Premium collection reports, outstanding receivables, commission payments, provider payments, expense breakdown, profit/loss by product/region. |
| FT-RPT-OPS-SALES-DETAIL | generate detailed sales and agent performance reports | track sales metrics and agent productivity | Must Have | Policies sold, premium generated, conversion rates, agent rankings, commission earned, pipeline analysis, sales by product/region/channel. |
| FT-RPT-OPS-PROVIDER-DETAIL | generate detailed provider network reports | analyze provider utilization and performance | Must Have | Provider directory, utilization by provider, claims frequency/severity, capitation payments, fee-for-service payments, network coverage by region. |
| FT-RPT-OPS-WELLNESS-DETAIL | generate detailed wellness program reports | track wellness participation and outcomes | Must Have | Screening participation, vaccination rates, challenge participation, fitness tracker activity, health risk assessment results, program ROI analysis. |
3.3 Financial Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-FIN-REVENUE-ANALYSIS | analyze premium revenue trends and composition | understand revenue drivers and forecast future revenue | Must Have | Revenue by product/region/channel/sales agent, trend analysis (MoM, YoY), revenue forecasting, premium rate analysis, payment collection rates. |
| FT-RPT-FIN-LOSS-RATIO | calculate and analyze loss ratios | assess product profitability and pricing adequacy | Must Have | Loss ratio by product/region/period, incurred claims vs earned premium, ultimate loss ratio projections, comparison to industry benchmarks, trend analysis. |
| FT-RPT-FIN-EXPENSE-ANALYSIS | analyze operating expenses and cost structure | identify cost optimization opportunities | Must Have | Expense breakdown (claims, commission, admin, IT, marketing), expense ratio by product, cost per member, cost trend analysis, budget vs actual. |
| FT-RPT-FIN-PROFITABILITY | analyze profitability by product, region, and segment | identify profitable and unprofitable segments | Must Have | Profit margin by product/region/customer segment, contribution margin analysis, break-even analysis, ROI by product, profitability trends. |
| FT-RPT-FIN-CASHFLOW | analyze cash flow and working capital | manage liquidity and financial health | Must Have | Cash inflows (premium collection), cash outflows (claims, commission, expenses), working capital analysis, cash flow forecasting, aging analysis of receivables/payables. |
3.4 Claims Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-CLM-FREQUENCY-SEVERITY | analyze claims frequency and severity | understand claims patterns and trends | Must Have | Claims frequency (count per 1000 members), average claim severity (amount per claim), frequency-severity distribution, trends by product/region/period. |
| FT-RPT-CLM-CATEGORY-ANALYSIS | analyze claims by category and diagnosis | identify high-cost conditions and utilization patterns | Must Have | Claims by category (inpatient, outpatient, pharmacy, dental, optical), top diagnoses by frequency/cost, chronic condition prevalence, preventable condition analysis. |
| FT-RPT-CLM-PROVIDER-ANALYSIS | analyze claims by provider | identify high-cost providers and utilization patterns | Must Have | Claims volume by provider, average cost per claim by provider, provider cost efficiency comparison, outlier detection, network vs non-network utilization. |
| FT-RPT-CLM-FRAUD-INDICATORS | identify potential fraud patterns in claims data | flag suspicious claims for investigation | Must Have | Duplicate claims detection, unusual billing patterns, high-frequency claimants, provider fraud indicators, member fraud patterns, fraud alert dashboard. |
| FT-RPT-CLM-TAT-ANALYSIS | analyze claims processing turnaround time | monitor and improve claims processing efficiency | Must Have | Average TAT by claim type/complexity, TAT distribution, SLA compliance rate, bottleneck identification, adjudicator performance, trend analysis. |
3.5 Membership Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-MBR-ENROLLMENT-TRENDS | analyze member enrollment and termination trends | understand member lifecycle and growth patterns | Must Have | New enrollments by period/product/channel, terminations by reason, net growth, seasonality analysis, enrollment funnel conversion rates. |
| FT-RPT-MBR-RETENTION-ANALYSIS | analyze member retention and churn | identify retention drivers and reduce churn | Must Have | Retention rate by product/cohort/period, churn rate analysis, termination reason breakdown, member tenure distribution, retention by sales channel/agent. |
| FT-RPT-MBR-DEMOGRAPHICS | analyze member demographics and segmentation | understand member composition and target segments | Must Have | Age/gender distribution, geographic distribution, product mix, family size, employer group analysis, corporate vs individual members. |
| FT-RPT-MBR-LIFETIME-VALUE | calculate and analyze member lifetime value | prioritize high-value member segments | Must Have | LTV calculation by segment/cohort, contribution margin per member, acquisition cost vs LTV, LTV trends over time, predictive LTV modeling. |
| FT-RPT-MBR-UTILIZATION | analyze member utilization patterns | understand healthcare consumption behavior | Must Have | Utilization rate (members with claims vs total), high utilizers identification, utilization by age/gender/product, preventive care utilization, wellness program participation. |
3.6 Sales Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-SLS-AGENT-PERFORMANCE | analyze sales agent performance | track productivity and identify top performers | Must Have | Policies sold per agent, premium generated, conversion rate, average policy value, agent rankings, commission earned, retention rate of sold policies. |
| FT-RPT-SLS-CHANNEL-ANALYSIS | analyze sales by channel | optimize channel strategy and resource allocation | Must Have | Sales by channel (direct, broker, corporate, online), channel conversion rates, cost per acquisition by channel, channel profitability, channel growth trends. |
| FT-RPT-SLS-PRODUCT-MIX | analyze sales product mix | understand product demand and optimize portfolio | Must Have | Policies sold by product, premium generated by product, product growth trends, cross-sell/up-sell analysis, product profitability. |
| FT-RPT-SLS-PIPELINE | analyze sales pipeline and conversion funnel | forecast sales and identify conversion bottlenecks | Must Have | Lead pipeline by stage, conversion rates by stage, average time in each stage, win/loss analysis, forecasted sales, pipeline velocity. |
3.7 Utilization Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-UTL-SERVICE-UTILIZATION | analyze utilization of medical services | understand healthcare consumption patterns | Must Have | Utilization by service type (inpatient, outpatient, pharmacy, etc.), utilization rate per 1000 members, high utilizers, seasonal patterns, regional variations. |
| FT-RPT-UTL-PROVIDER-PATTERNS | analyze provider utilization patterns | optimize provider network and contracts | Must Have | Most utilized providers, provider market share, network vs non-network utilization, provider concentration, geographic coverage gaps. |
| FT-RPT-UTL-COST-EFFICIENCY | analyze cost efficiency of utilization | identify cost optimization opportunities | Must Have | Cost per service type, cost per member per month, cost variation by provider/region, preventable costs, generic vs brand drug utilization. |
3.8 Provider Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-PRV-PERFORMANCE | analyze provider performance metrics | identify high-performing and underperforming providers | Must Have | Provider quality scores, claims approval rate, average cost per visit, member satisfaction, readmission rates, adherence to protocols. |
| FT-RPT-PRV-COST-ANALYSIS | analyze provider costs and efficiency | negotiate contracts and optimize network | Must Have | Cost per provider vs network average, fee schedule compliance, outlier identification, capitation vs fee-for-service cost comparison. |
| FT-RPT-PRV-NETWORK-COVERAGE | analyze provider network coverage | identify gaps and expansion opportunities | Must Have | Provider density by region/specialty, member-to-provider ratio, geographic coverage maps, network adequacy assessment, specialty coverage gaps. |
3.9 Wellness Analytics
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-WELL-PARTICIPATION | analyze wellness program participation | measure engagement and identify improvement areas | Must Have | Participation rate by program, demographic breakdown, repeat participation, engagement trends, barriers to participation analysis. |
| FT-RPT-WELL-OUTCOMES | analyze wellness program health outcomes | measure program effectiveness | Must Have | Biometric improvements, risk score changes, chronic disease management outcomes, preventive care utilization, lifestyle behavior changes. |
| FT-RPT-WELL-ROI | calculate wellness program ROI | justify investment in wellness programs | Must Have | Program costs vs savings (reduced claims), cost per participant, healthcare cost trend for participants vs non-participants, productivity gains, engagement ROI. |
3.10 Custom Report Builder
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-CUSTOM-BUILDER | build custom reports using drag-and-drop interface | create ad-hoc reports without IT assistance | Must Have | Drag-and-drop fields, filters, grouping, sorting. Available data sources: claims, members, policies, providers, payments, wellness. Preview before generating. |
| FT-RPT-CUSTOM-SAVE-SHARE | save and share custom reports | reuse reports and collaborate with team | Must Have | Save report definition, name and categorize, share with users/roles, version history, clone and modify existing reports. |
| FT-RPT-CUSTOM-VISUALIZATIONS | add visualizations to custom reports | present data in charts and graphs | Must Have | Chart types: bar, line, pie, scatter, heatmap. Customize colors, labels, legends. Multiple visualizations per report, export charts as images. |
| FT-RPT-CUSTOM-CALCULATIONS | add calculated fields to custom reports | perform custom analytics | Must Have | Formula builder with functions (sum, avg, count, percentage, ratios), aggregations (group by), conditional calculations, date calculations. |
3.11 Scheduled Reports
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-SCHEDULE-CONFIG | schedule reports for automated generation | receive regular reports without manual effort | Must Have | Schedule frequency: daily, weekly, monthly, quarterly, annual. Time of day, day of week/month. Effective date range, expiration. |
| FT-RPT-SCHEDULE-DISTRIBUTION | configure automated report distribution | deliver reports to stakeholders automatically | Must Have | Email distribution list, attachment format (PDF, Excel), report portal notification, FTP/SFTP delivery option, distribution log. |
| FT-RPT-SCHEDULE-HISTORY | view history of scheduled report executions | track delivery and troubleshoot issues | Must Have | Execution log (success/failure), generated report archive, download previous reports, error details, retry failed reports. |
3.12 Data Exports
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-EXPORT-EXCEL | export reports to Excel format | perform additional analysis in spreadsheets | Must Have | Multi-sheet workbooks, formatted cells, formulas, charts, preserve styling, large dataset support (100K+ rows). |
| FT-RPT-EXPORT-PDF | export reports to PDF format | share professional formatted reports | Must Have | Professional layout, company branding, page headers/footers, table of contents, charts and visualizations, print-ready format. |
| FT-RPT-EXPORT-CSV | export reports to CSV format | import data into other systems | Must Have | Configurable delimiter, UTF-8 encoding, header row option, large file support, streaming export for big datasets. |
| FT-RPT-EXPORT-JSON | export reports to JSON format | integrate with APIs and applications | Must Have | Structured JSON schema, nested objects support, metadata included, pagination for large datasets, API endpoint for exports. |
3.13 Regulatory Reporting
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-REG-TIRA-RETURNS | generate TIRA statutory returns | comply with regulatory requirements | Must Have | TIRA quarterly/annual returns, prescribed format, data validation, audit trail, electronic submission format, archival. |
| FT-RPT-REG-TAX-RETURNS | generate tax returns and supporting documents | comply with tax obligations | Must Have | VAT returns, income tax supporting schedules, withholding tax reports, prescribed format, validation, archival. |
| FT-RPT-REG-STATUTORY-ACCOUNTS | generate statutory financial statements | meet regulatory and governance requirements | Must Have | Balance sheet, income statement, cash flow statement, notes to accounts, IFRS 17 compliant, trial balance, audit trail. |
| FT-RPT-REG-COMPLIANCE | generate compliance monitoring reports | demonstrate regulatory compliance | Must Have | Solvency margin calculations, investment compliance, governance compliance, complaint registers, required disclosures. |
3.14 Adhoc Querying
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-ADHOC-QUERY-BUILDER | build ad-hoc queries using query builder | answer specific business questions quickly | Must Have | Visual query builder, filter conditions (AND/OR), sorting, aggregations, limit results, save queries for reuse. |
| FT-RPT-ADHOC-QUICK-FILTERS | apply quick filters to existing reports | slice data by different dimensions | Must Have | Common filters: date range, product, region, provider, status. Filter persistence, clear all filters, filter presets. |
| FT-RPT-ADHOC-DATA-PREVIEW | preview data before generating full report | verify query results and save time | Must Have | Sample data preview (first 100 rows), record count, performance estimation, modify query before full execution. |
3.15 Report Management
| Feature Code | I Want To | So That I Can | Priority | Notes |
|---|---|---|---|---|
| FT-RPT-MGMT-CATALOG | browse report catalog organized by category | find available reports easily | Must Have | Categories: executive, operational, financial, claims, membership, sales, provider, wellness, regulatory. Search by name/description, favorites, recently used. |
| FT-RPT-MGMT-ACCESS-CONTROL | control access to reports based on roles | ensure data security and privacy | Must Have | Role-based access (executive, manager, analyst, viewer), report permissions (view, edit, share, export), data-level security (filter by user's region/department). |
| FT-RPT-MGMT-AUDIT-TRAIL | maintain audit trail of report access and generation | track usage and ensure compliance | Must Have | Log who accessed which report, when, parameters used, export actions, modifications to report definitions, retention period 7 years. |
| FT-RPT-MGMT-VERSIONING | manage report versions | track changes and rollback if needed | Must Have | Version history for report definitions, compare versions, rollback to previous version, change notes, archive old versions. |
4 Detailed Feature Requirements
4.1 Ft Rpt Exec Kpi Dashboard
4.1.1 Priority
Must Have
4.1.2 User Story
As a CEO, I want to view executive KPI dashboard with real-time metrics so that I can monitor overall business performance at a glance
4.1.3 Preconditions
User authenticated with executive role, data populated in database
4.1.4 Postconditions
KPI dashboard displayed with real-time metrics, trend indicators, and comparison to targets
4.1.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXEC-KPI-DASHBOARD-TC-001 | Verify all key metrics displayed (members, revenue, claims ratio, profit, new policies, retention, avg claim cost, CSAT) | High |
| EXEC-KPI-DASHBOARD-TC-002 | Verify real-time data updates | High |
| EXEC-KPI-DASHBOARD-TC-003 | Verify trend indicators (up/down arrows, % change) | High |
| EXEC-KPI-DASHBOARD-TC-004 | Verify comparison to targets/benchmarks | High |
| EXEC-KPI-DASHBOARD-TC-005 | Verify date range selection (MTD, QTD, YTD) | Medium |
| EXEC-KPI-DASHBOARD-TC-006 | Verify dashboard loads within 3 seconds | High |
4.2 Ft Rpt Exec Financial Summary
4.2.1 Priority
Must Have
4.2.2 User Story
As a CFO, I want to view financial performance summary dashboard so that I can track revenue, expenses, profitability trends
4.2.3 Preconditions
Financial data available, user has CFO/finance role
4.2.4 Postconditions
Financial summary dashboard displayed with revenue, expenses, profit trends, loss ratio, combined ratio
4.2.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXEC-FINANCIAL-SUMMARY-TC-001 | Verify revenue breakdown by product/region | High |
| EXEC-FINANCIAL-SUMMARY-TC-002 | Verify expense analysis with categorization | High |
| EXEC-FINANCIAL-SUMMARY-TC-003 | Verify profit margin trends over time | High |
| EXEC-FINANCIAL-SUMMARY-TC-004 | Verify loss ratio calculation by product | High |
| EXEC-FINANCIAL-SUMMARY-TC-005 | Verify combined ratio calculation | High |
| EXEC-FINANCIAL-SUMMARY-TC-006 | Verify cash flow summary | High |
| EXEC-FINANCIAL-SUMMARY-TC-007 | Verify monthly/quarterly/yearly view toggle | Medium |
4.3 Ft Rpt Exec Claims Overview
4.3.1 Priority
Must Have
4.3.2 User Story
As a COO, I want to view claims performance overview dashboard so that I can monitor claims trends and identify issues
4.3.3 Preconditions
Claims data available, user has executive role
4.3.4 Postconditions
Claims overview dashboard displayed with key metrics, trends, and alerts
4.3.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXEC-CLAIMS-OVERVIEW-TC-001 | Verify claims submitted vs settled count | High |
| EXEC-CLAIMS-OVERVIEW-TC-002 | Verify average TAT calculation | High |
| EXEC-CLAIMS-OVERVIEW-TC-003 | Verify claims ratio display | High |
| EXEC-CLAIMS-OVERVIEW-TC-004 | Verify fraud alerts visible | High |
| EXEC-CLAIMS-OVERVIEW-TC-005 | Verify high-value claims flagged | High |
| EXEC-CLAIMS-OVERVIEW-TC-006 | Verify claims by category breakdown | Medium |
| EXEC-CLAIMS-OVERVIEW-TC-007 | Verify pending claims backlog shown | High |
4.4 Ft Rpt Exec Membership Trends
4.4.1 Priority
Must Have
4.4.2 User Story
As an executive, I want to view membership growth and retention dashboard so that I can track enrollment trends and member lifecycle
4.4.3 Preconditions
Membership data available, user authenticated
4.4.4 Postconditions
Membership trends dashboard displayed with growth, retention, churn metrics
4.4.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXEC-MEMBERSHIP-TRENDS-TC-001 | Verify total members by product/region | High |
| EXEC-MEMBERSHIP-TRENDS-TC-002 | Verify new enrollments over time | High |
| EXEC-MEMBERSHIP-TRENDS-TC-003 | Verify terminations analysis | High |
| EXEC-MEMBERSHIP-TRENDS-TC-004 | Verify retention rate calculation | High |
| EXEC-MEMBERSHIP-TRENDS-TC-005 | Verify churn analysis with reasons | High |
| EXEC-MEMBERSHIP-TRENDS-TC-006 | Verify member demographics breakdown | Medium |
| EXEC-MEMBERSHIP-TRENDS-TC-007 | Verify lifetime value trends | Medium |
4.5 Ft Rpt Exec Drilldown
4.5.1 Priority
Must Have
4.5.2 User Story
As an executive, I want to drill down from executive dashboard to detailed reports so that I can investigate specific metrics and trends
4.5.3 Preconditions
Executive dashboard displayed, metrics have underlying detail data
4.5.4 Postconditions
Detailed report displayed with context preserved, filters applied
4.5.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXEC-DRILLDOWN-TC-001 | Verify click on metric opens detailed report | High |
| EXEC-DRILLDOWN-TC-002 | Verify filters carried forward to detail view | High |
| EXEC-DRILLDOWN-TC-003 | Verify breadcrumb navigation available | Medium |
| EXEC-DRILLDOWN-TC-004 | Verify export option available in drill-down | Medium |
| EXEC-DRILLDOWN-TC-005 | Verify back navigation returns to dashboard | Medium |
| EXEC-DRILLDOWN-TC-006 | Verify context maintained across drill levels | High |
4.6 Ft Rpt Ops Claims Detail
4.6.1 Priority
Must Have
4.6.2 User Story
As a claims manager, I want to generate detailed claims reports so that I can analyze claims by various dimensions
4.6.3 Preconditions
Claims data available, user has claims role
4.6.4 Postconditions
Detailed claims report generated with filters, grouping, and export options
4.6.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-CLAIMS-DETAIL-TC-001 | Verify filter by date range works | High |
| OPS-CLAIMS-DETAIL-TC-002 | Verify filter by product/provider/type/status/amount | High |
| OPS-CLAIMS-DETAIL-TC-003 | Verify group by product/provider/diagnosis/member | High |
| OPS-CLAIMS-DETAIL-TC-004 | Verify export to Excel format | High |
| OPS-CLAIMS-DETAIL-TC-005 | Verify export to PDF format | High |
| OPS-CLAIMS-DETAIL-TC-006 | Verify export to CSV format | High |
| OPS-CLAIMS-DETAIL-TC-007 | Verify pagination for large result sets | Medium |
4.7 Ft Rpt Ops Membership Detail
4.7.1 Priority
Must Have
4.7.2 User Story
As a membership manager, I want to generate detailed membership reports so that I can analyze member demographics and status
4.7.3 Preconditions
Membership data available, user authenticated
4.7.4 Postconditions
Membership detail report generated with comprehensive member information
4.7.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-MEMBERSHIP-DETAIL-TC-001 | Verify active/inactive member filtering | High |
| OPS-MEMBERSHIP-DETAIL-TC-002 | Verify enrollments/terminations by period | High |
| OPS-MEMBERSHIP-DETAIL-TC-003 | Verify demographics breakdown (age, gender, location) | High |
| OPS-MEMBERSHIP-DETAIL-TC-004 | Verify policy details included | High |
| OPS-MEMBERSHIP-DETAIL-TC-005 | Verify dependent analysis | Medium |
| OPS-MEMBERSHIP-DETAIL-TC-006 | Verify export functionality | High |
4.8 Ft Rpt Ops Financial Detail
4.8.1 Priority
Must Have
4.8.2 User Story
As a finance manager, I want to generate detailed financial reports so that I can analyze revenue, expenses, and profitability
4.8.3 Preconditions
Financial data available, user has finance role
4.8.4 Postconditions
Financial detail report generated with comprehensive financial data
4.8.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-FINANCIAL-DETAIL-TC-001 | Verify premium collection report | High |
| OPS-FINANCIAL-DETAIL-TC-002 | Verify outstanding receivables report | High |
| OPS-FINANCIAL-DETAIL-TC-003 | Verify commission payments report | High |
| OPS-FINANCIAL-DETAIL-TC-004 | Verify provider payments report | High |
| OPS-FINANCIAL-DETAIL-TC-005 | Verify expense breakdown report | High |
| OPS-FINANCIAL-DETAIL-TC-006 | Verify profit/loss by product/region | High |
| OPS-FINANCIAL-DETAIL-TC-007 | Verify multi-currency support | High |
4.9 Ft Rpt Ops Sales Detail
4.9.1 Priority
Must Have
4.9.2 User Story
As a sales manager, I want to generate detailed sales and agent performance reports so that I can track sales metrics and agent productivity
4.9.3 Preconditions
Sales data available, user has sales role
4.9.4 Postconditions
Sales detail report generated with agent performance metrics
4.9.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-SALES-DETAIL-TC-001 | Verify policies sold by period | High |
| OPS-SALES-DETAIL-TC-002 | Verify premium generated report | High |
| OPS-SALES-DETAIL-TC-003 | Verify conversion rates calculation | High |
| OPS-SALES-DETAIL-TC-004 | Verify agent rankings display | High |
| OPS-SALES-DETAIL-TC-005 | Verify commission earned report | High |
| OPS-SALES-DETAIL-TC-006 | Verify pipeline analysis | Medium |
| OPS-SALES-DETAIL-TC-007 | Verify sales by product/region/channel | High |
4.10 Ft Rpt Ops Provider Detail
4.10.1 Priority
Must Have
4.10.2 User Story
As a provider network manager, I want to generate detailed provider network reports so that I can analyze provider utilization and performance
4.10.3 Preconditions
Provider data available, user has provider network role
4.10.4 Postconditions
Provider detail report generated with utilization and performance metrics
4.10.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-PROVIDER-DETAIL-TC-001 | Verify provider directory listing | High |
| OPS-PROVIDER-DETAIL-TC-002 | Verify utilization by provider | High |
| OPS-PROVIDER-DETAIL-TC-003 | Verify claims frequency/severity by provider | High |
| OPS-PROVIDER-DETAIL-TC-004 | Verify capitation payments report | High |
| OPS-PROVIDER-DETAIL-TC-005 | Verify fee-for-service payments report | High |
| OPS-PROVIDER-DETAIL-TC-006 | Verify network coverage by region | Medium |
4.11 Ft Rpt Ops Wellness Detail
4.11.1 Priority
Must Have
4.11.2 User Story
As a wellness manager, I want to generate detailed wellness program reports so that I can track wellness participation and outcomes
4.11.3 Preconditions
Wellness data available, user has wellness role
4.11.4 Postconditions
Wellness detail report generated with participation and outcomes metrics
4.11.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| OPS-WELLNESS-DETAIL-TC-001 | Verify screening participation rates | High |
| OPS-WELLNESS-DETAIL-TC-002 | Verify vaccination rates report | High |
| OPS-WELLNESS-DETAIL-TC-003 | Verify challenge participation metrics | High |
| OPS-WELLNESS-DETAIL-TC-004 | Verify fitness tracker activity stats | Medium |
| OPS-WELLNESS-DETAIL-TC-005 | Verify HRA results summary | High |
| OPS-WELLNESS-DETAIL-TC-006 | Verify wellness program ROI analysis | High |
4.12 Ft Rpt Fin Revenue Analysis
4.12.1 Priority
Must Have
4.12.2 User Story
As a CFO, I want to analyze premium revenue trends and composition so that I can understand revenue drivers and forecast future revenue
4.12.3 Preconditions
Revenue data available, user has finance role
4.12.4 Postconditions
Revenue analysis report generated with trends, composition, and forecasts
4.12.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| FIN-REVENUE-ANALYSIS-TC-001 | Verify revenue by product breakdown | High |
| FIN-REVENUE-ANALYSIS-TC-002 | Verify revenue by region/channel/agent | High |
| FIN-REVENUE-ANALYSIS-TC-003 | Verify trend analysis (MoM, YoY) | High |
| FIN-REVENUE-ANALYSIS-TC-004 | Verify revenue forecasting capability | Medium |
| FIN-REVENUE-ANALYSIS-TC-005 | Verify premium rate analysis | Medium |
| FIN-REVENUE-ANALYSIS-TC-006 | Verify payment collection rates | High |
4.13 Ft Rpt Fin Loss Ratio
4.13.1 Priority
Must Have
4.13.2 User Story
As an actuary, I want to calculate and analyze loss ratios so that I can assess product profitability and pricing adequacy
4.13.3 Preconditions
Claims and premium data available, user has finance/actuarial role
4.13.4 Postconditions
Loss ratio analysis report generated with calculations by product, region, period
4.13.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| FIN-LOSS-RATIO-TC-001 | Verify loss ratio calculation formula (incurred claims / earned premium) | High |
| FIN-LOSS-RATIO-TC-002 | Verify loss ratio by product | High |
| FIN-LOSS-RATIO-TC-003 | Verify loss ratio by region/period | High |
| FIN-LOSS-RATIO-TC-004 | Verify incurred vs earned premium calculation | High |
| FIN-LOSS-RATIO-TC-005 | Verify ultimate loss ratio projections | Medium |
| FIN-LOSS-RATIO-TC-006 | Verify comparison to industry benchmarks | Medium |
| FIN-LOSS-RATIO-TC-007 | Verify trend analysis over time | High |
4.14 Ft Rpt Fin Expense Analysis
4.14.1 Priority
Must Have
4.14.2 User Story
As a CFO, I want to analyze operating expenses and cost structure so that I can identify cost optimization opportunities
4.14.3 Preconditions
Expense data available, user has finance role
4.14.4 Postconditions
Expense analysis report generated with breakdown, ratios, trends
4.14.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| FIN-EXPENSE-ANALYSIS-TC-001 | Verify expense breakdown by category (claims, commission, admin, IT, marketing) | High |
| FIN-EXPENSE-ANALYSIS-TC-002 | Verify expense ratio by product calculation | High |
| FIN-EXPENSE-ANALYSIS-TC-003 | Verify cost per member calculation | High |
| FIN-EXPENSE-ANALYSIS-TC-004 | Verify cost trend analysis | High |
| FIN-EXPENSE-ANALYSIS-TC-005 | Verify budget vs actual comparison | High |
| FIN-EXPENSE-ANALYSIS-TC-006 | Verify variance analysis with explanations | Medium |
4.15 Ft Rpt Fin Profitability
4.15.1 Priority
Must Have
4.15.2 User Story
As a CFO, I want to analyze profitability by product, region, and segment so that I can identify profitable and unprofitable segments
4.15.3 Preconditions
Financial data available across all dimensions, user has finance role
4.15.4 Postconditions
Profitability analysis report generated with multi-dimensional breakdown
4.15.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| FIN-PROFITABILITY-TC-001 | Verify profit margin by product calculation | High |
| FIN-PROFITABILITY-TC-002 | Verify profitability by region | High |
| FIN-PROFITABILITY-TC-003 | Verify profitability by customer segment | High |
| FIN-PROFITABILITY-TC-004 | Verify contribution margin analysis | High |
| FIN-PROFITABILITY-TC-005 | Verify break-even analysis | Medium |
| FIN-PROFITABILITY-TC-006 | Verify ROI by product calculation | High |
| FIN-PROFITABILITY-TC-007 | Verify profitability trends over time | High |
4.16 Ft Rpt Fin Cashflow
4.16.1 Priority
Must Have
4.16.2 User Story
As a CFO, I want to analyze cash flow and working capital so that I can manage liquidity and financial health
4.16.3 Preconditions
Cash flow data available, user has finance role
4.16.4 Postconditions
Cash flow analysis report generated with inflows, outflows, forecasts
4.16.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| FIN-CASHFLOW-TC-001 | Verify cash inflows (premium collection) tracking | High |
| FIN-CASHFLOW-TC-002 | Verify cash outflows (claims, commission, expenses) tracking | High |
| FIN-CASHFLOW-TC-003 | Verify working capital analysis | High |
| FIN-CASHFLOW-TC-004 | Verify cash flow forecasting | Medium |
| FIN-CASHFLOW-TC-005 | Verify aging analysis of receivables | High |
| FIN-CASHFLOW-TC-006 | Verify aging analysis of payables | High |
4.17 Ft Rpt Clm Frequency Severity
4.17.1 Priority
Must Have
4.17.2 User Story
As an actuarial analyst, I want to analyze claims frequency and severity so that I can understand claims patterns and trends
4.17.3 Preconditions
Claims data available with member counts, user has claims/actuarial role
4.17.4 Postconditions
Frequency-severity analysis report generated with distributions and trends
4.17.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CLM-FREQUENCY-SEVERITY-TC-001 | Verify claims frequency calculation (count per 1000 members) | High |
| CLM-FREQUENCY-SEVERITY-TC-002 | Verify average claim severity calculation (amount per claim) | High |
| CLM-FREQUENCY-SEVERITY-TC-003 | Verify frequency-severity distribution chart | High |
| CLM-FREQUENCY-SEVERITY-TC-004 | Verify trends by product analysis | High |
| CLM-FREQUENCY-SEVERITY-TC-005 | Verify trends by region analysis | High |
| CLM-FREQUENCY-SEVERITY-TC-006 | Verify trends by period (MoM, YoY) | High |
4.18 Ft Rpt Clm Category Analysis
4.18.1 Priority
Must Have
4.18.2 User Story
As a claims manager, I want to analyze claims by category and diagnosis so that I can identify high-cost conditions and utilization patterns
4.18.3 Preconditions
Claims data with categories and diagnoses, user has claims role
4.18.4 Postconditions
Category analysis report generated with cost drivers and patterns
4.18.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CLM-CATEGORY-ANALYSIS-TC-001 | Verify claims by category (inpatient, outpatient, pharmacy, dental, optical) | High |
| CLM-CATEGORY-ANALYSIS-TC-002 | Verify top diagnoses by frequency | High |
| CLM-CATEGORY-ANALYSIS-TC-003 | Verify top diagnoses by cost | High |
| CLM-CATEGORY-ANALYSIS-TC-004 | Verify chronic condition prevalence | High |
| CLM-CATEGORY-ANALYSIS-TC-005 | Verify preventable condition analysis | Medium |
| CLM-CATEGORY-ANALYSIS-TC-006 | Verify cost per category calculation | High |
4.19 Ft Rpt Clm Provider Analysis
4.19.1 Priority
Must Have
4.19.2 User Story
As a provider network manager, I want to analyze claims by provider so that I can identify high-cost providers and utilization patterns
4.19.3 Preconditions
Claims data with provider information, user has provider network role
4.19.4 Postconditions
Provider analysis report generated with cost and utilization metrics
4.19.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CLM-PROVIDER-ANALYSIS-TC-001 | Verify claims volume by provider | High |
| CLM-PROVIDER-ANALYSIS-TC-002 | Verify average cost per claim by provider | High |
| CLM-PROVIDER-ANALYSIS-TC-003 | Verify provider cost efficiency comparison | High |
| CLM-PROVIDER-ANALYSIS-TC-004 | Verify outlier detection (unusually high costs) | High |
| CLM-PROVIDER-ANALYSIS-TC-005 | Verify network vs non-network utilization | High |
| CLM-PROVIDER-ANALYSIS-TC-006 | Verify provider ranking by cost/volume | Medium |
4.20 Ft Rpt Clm Fraud Indicators
4.20.1 Priority
Must Have
4.20.2 User Story
As a fraud investigator, I want to identify potential fraud patterns in claims data so that I can flag suspicious claims for investigation
4.20.3 Preconditions
Claims data available, fraud detection rules configured, user has fraud investigation role
4.20.4 Postconditions
Fraud indicators report generated with flagged claims and patterns
4.20.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CLM-FRAUD-INDICATORS-TC-001 | Verify duplicate claims detection | High |
| CLM-FRAUD-INDICATORS-TC-002 | Verify unusual billing patterns flagged | High |
| CLM-FRAUD-INDICATORS-TC-003 | Verify high-frequency claimants identified | High |
| CLM-FRAUD-INDICATORS-TC-004 | Verify provider fraud indicators tracked | High |
| CLM-FRAUD-INDICATORS-TC-005 | Verify member fraud patterns identified | High |
| CLM-FRAUD-INDICATORS-TC-006 | Verify fraud alert dashboard available | High |
| CLM-FRAUD-INDICATORS-TC-007 | Verify flagged claims can be exported for investigation | Medium |
4.21 Ft Rpt Clm Tat Analysis
4.21.1 Priority
Must Have
4.21.2 User Story
As a claims manager, I want to analyze claims processing turnaround time so that I can monitor and improve claims processing efficiency
4.21.3 Preconditions
Claims data with timestamps, SLA targets configured, user has claims role
4.21.4 Postconditions
TAT analysis report generated with efficiency metrics and bottlenecks
4.21.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CLM-TAT-ANALYSIS-TC-001 | Verify average TAT by claim type | High |
| CLM-TAT-ANALYSIS-TC-002 | Verify average TAT by complexity | High |
| CLM-TAT-ANALYSIS-TC-003 | Verify TAT distribution (histogram) | Medium |
| CLM-TAT-ANALYSIS-TC-004 | Verify SLA compliance rate calculation | High |
| CLM-TAT-ANALYSIS-TC-005 | Verify bottleneck identification | High |
| CLM-TAT-ANALYSIS-TC-006 | Verify adjudicator performance comparison | High |
| CLM-TAT-ANALYSIS-TC-007 | Verify trend analysis over time | High |
4.22 Ft Rpt Mbr Enrollment Trends
4.22.1 Priority
Must Have
4.22.2 User Story
As a membership manager, I want to analyze member enrollment and termination trends so that I can understand member lifecycle and growth patterns
4.22.3 Preconditions
Membership data available, user has membership role
4.22.4 Postconditions
Enrollment trends report generated with growth metrics and patterns
4.22.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MBR-ENROLLMENT-TRENDS-TC-001 | Verify new enrollments by period | High |
| MBR-ENROLLMENT-TRENDS-TC-002 | Verify enrollments by product analysis | High |
| MBR-ENROLLMENT-TRENDS-TC-003 | Verify enrollments by channel (direct, broker, corporate) | High |
| MBR-ENROLLMENT-TRENDS-TC-004 | Verify terminations by reason breakdown | High |
| MBR-ENROLLMENT-TRENDS-TC-005 | Verify net growth calculation | High |
| MBR-ENROLLMENT-TRENDS-TC-006 | Verify seasonality analysis | Medium |
| MBR-ENROLLMENT-TRENDS-TC-007 | Verify enrollment funnel conversion rates | High |
4.23 Ft Rpt Mbr Retention Analysis
4.23.1 Priority
Must Have
4.23.2 User Story
As a marketing manager, I want to analyze member retention and churn so that I can identify retention drivers and reduce churn
4.23.3 Preconditions
Membership data with enrollment/termination dates, user has membership/marketing role
4.23.4 Postconditions
Retention analysis report generated with retention rate, churn rate, and drivers
4.23.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MBR-RETENTION-ANALYSIS-TC-001 | Verify retention rate by product calculation | High |
| MBR-RETENTION-ANALYSIS-TC-002 | Verify retention by cohort analysis | High |
| MBR-RETENTION-ANALYSIS-TC-003 | Verify retention by period (monthly, annual) | High |
| MBR-RETENTION-ANALYSIS-TC-004 | Verify churn rate analysis | High |
| MBR-RETENTION-ANALYSIS-TC-005 | Verify termination reason breakdown | High |
| MBR-RETENTION-ANALYSIS-TC-006 | Verify member tenure distribution | Medium |
| MBR-RETENTION-ANALYSIS-TC-007 | Verify retention by sales channel/agent | High |
4.24 Ft Rpt Mbr Demographics
4.24.1 Priority
Must Have
4.24.2 User Story
As a marketing manager, I want to analyze member demographics and segmentation so that I can understand member composition and target segments
4.24.3 Preconditions
Member demographic data available, user has membership/marketing role
4.24.4 Postconditions
Demographics report generated with breakdowns by age, gender, location, product, etc.
4.24.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MBR-DEMOGRAPHICS-TC-001 | Verify age distribution analysis | High |
| MBR-DEMOGRAPHICS-TC-002 | Verify gender distribution analysis | High |
| MBR-DEMOGRAPHICS-TC-003 | Verify geographic distribution | High |
| MBR-DEMOGRAPHICS-TC-004 | Verify product mix analysis | High |
| MBR-DEMOGRAPHICS-TC-005 | Verify family size distribution | Medium |
| MBR-DEMOGRAPHICS-TC-006 | Verify employer group analysis | High |
| MBR-DEMOGRAPHICS-TC-007 | Verify corporate vs individual member breakdown | High |
4.25 Ft Rpt Mbr Lifetime Value
4.25.1 Priority
Must Have
4.25.2 User Story
As a marketing manager, I want to calculate and analyze member lifetime value so that I can prioritize high-value member segments
4.25.3 Preconditions
Member revenue and cost data available, user has marketing/finance role
4.25.4 Postconditions
LTV analysis report generated with calculations by segment and cohort
4.25.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MBR-LIFETIME-VALUE-TC-001 | Verify LTV calculation by segment | High |
| MBR-LIFETIME-VALUE-TC-002 | Verify LTV by cohort analysis | High |
| MBR-LIFETIME-VALUE-TC-003 | Verify contribution margin per member calculation | High |
| MBR-LIFETIME-VALUE-TC-004 | Verify acquisition cost vs LTV comparison | High |
| MBR-LIFETIME-VALUE-TC-005 | Verify LTV trends over time | High |
| MBR-LIFETIME-VALUE-TC-006 | Verify predictive LTV modeling available | Medium |
4.26 Ft Rpt Mbr Utilization
4.26.1 Priority
Must Have
4.26.2 User Story
As a claims manager, I want to analyze member utilization patterns so that I can understand healthcare consumption behavior
4.26.3 Preconditions
Member and claims data available, user has claims/membership role
4.26.4 Postconditions
Member utilization report generated with utilization metrics and patterns
4.26.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MBR-UTILIZATION-TC-001 | Verify utilization rate (members with claims vs total) | High |
| MBR-UTILIZATION-TC-002 | Verify high utilizers identification | High |
| MBR-UTILIZATION-TC-003 | Verify utilization by age group | High |
| MBR-UTILIZATION-TC-004 | Verify utilization by gender | High |
| MBR-UTILIZATION-TC-005 | Verify utilization by product | High |
| MBR-UTILIZATION-TC-006 | Verify preventive care utilization tracking | High |
| MBR-UTILIZATION-TC-007 | Verify wellness program participation correlation | Medium |
4.27 Ft Rpt Sls Agent Performance
4.27.1 Priority
Must Have
4.27.2 User Story
As a sales manager, I want to analyze sales agent performance so that I can track productivity and identify top performers
4.27.3 Preconditions
Sales data available, user has sales management role
4.27.4 Postconditions
Agent performance report generated with rankings and metrics
4.27.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SLS-AGENT-PERFORMANCE-TC-001 | Verify policies sold per agent | High |
| SLS-AGENT-PERFORMANCE-TC-002 | Verify premium generated per agent | High |
| SLS-AGENT-PERFORMANCE-TC-003 | Verify conversion rate by agent | High |
| SLS-AGENT-PERFORMANCE-TC-004 | Verify average policy value by agent | High |
| SLS-AGENT-PERFORMANCE-TC-005 | Verify agent rankings | High |
| SLS-AGENT-PERFORMANCE-TC-006 | Verify commission earned by agent | High |
| SLS-AGENT-PERFORMANCE-TC-007 | Verify retention rate of sold policies | High |
4.28 Ft Rpt Sls Channel Analysis
4.28.1 Priority
Must Have
4.28.2 User Story
As a sales manager, I want to analyze sales by channel so that I can optimize channel strategy and resource allocation
4.28.3 Preconditions
Sales data with channel information, user has sales management role
4.28.4 Postconditions
Channel analysis report generated with performance by channel
4.28.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SLS-CHANNEL-ANALYSIS-TC-001 | Verify sales by channel (direct, broker, corporate, online) | High |
| SLS-CHANNEL-ANALYSIS-TC-002 | Verify channel conversion rates | High |
| SLS-CHANNEL-ANALYSIS-TC-003 | Verify cost per acquisition by channel | High |
| SLS-CHANNEL-ANALYSIS-TC-004 | Verify channel profitability analysis | High |
| SLS-CHANNEL-ANALYSIS-TC-005 | Verify channel growth trends | High |
| SLS-CHANNEL-ANALYSIS-TC-006 | Verify channel market share | Medium |
4.29 Ft Rpt Sls Product Mix
4.29.1 Priority
Must Have
4.29.2 User Story
As a product manager, I want to analyze sales product mix so that I can understand product demand and optimize portfolio
4.29.3 Preconditions
Sales data by product, user has product/sales management role
4.29.4 Postconditions
Product mix analysis report generated with demand patterns
4.29.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SLS-PRODUCT-MIX-TC-001 | Verify policies sold by product | High |
| SLS-PRODUCT-MIX-TC-002 | Verify premium generated by product | High |
| SLS-PRODUCT-MIX-TC-003 | Verify product growth trends | High |
| SLS-PRODUCT-MIX-TC-004 | Verify cross-sell analysis | High |
| SLS-PRODUCT-MIX-TC-005 | Verify up-sell analysis | High |
| SLS-PRODUCT-MIX-TC-006 | Verify product profitability correlation | High |
4.30 Ft Rpt Sls Pipeline
4.30.1 Priority
Must Have
4.30.2 User Story
As a sales manager, I want to analyze sales pipeline and conversion funnel so that I can forecast sales and identify conversion bottlenecks
4.30.3 Preconditions
Pipeline data available, user has sales management role
4.30.4 Postconditions
Pipeline analysis report generated with forecasts and conversion metrics
4.30.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SLS-PIPELINE-TC-001 | Verify lead pipeline by stage | High |
| SLS-PIPELINE-TC-002 | Verify conversion rates by stage | High |
| SLS-PIPELINE-TC-003 | Verify average time in each stage | High |
| SLS-PIPELINE-TC-004 | Verify win/loss analysis | High |
| SLS-PIPELINE-TC-005 | Verify forecasted sales calculation | High |
| SLS-PIPELINE-TC-006 | Verify pipeline velocity metrics | Medium |
4.31 Ft Rpt Utl Service Utilization
4.31.1 Priority
Must Have
4.31.2 User Story
As a utilization manager, I want to analyze utilization of medical services so that I can understand healthcare consumption patterns
4.31.3 Preconditions
Claims data with service types, member counts, user has utilization management role
4.31.4 Postconditions
Service utilization report generated with patterns and rates
4.31.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| UTL-SERVICE-UTILIZATION-TC-001 | Verify utilization by service type (inpatient, outpatient, pharmacy, etc.) | High |
| UTL-SERVICE-UTILIZATION-TC-002 | Verify utilization rate per 1000 members | High |
| UTL-SERVICE-UTILIZATION-TC-003 | Verify high utilizers identification | High |
| UTL-SERVICE-UTILIZATION-TC-004 | Verify seasonal patterns analysis | Medium |
| UTL-SERVICE-UTILIZATION-TC-005 | Verify regional variations | High |
| UTL-SERVICE-UTILIZATION-TC-006 | Verify trend analysis over time | High |
4.32 Ft Rpt Utl Provider Patterns
4.32.1 Priority
Must Have
4.32.2 User Story
As a provider network manager, I want to analyze provider utilization patterns so that I can optimize provider network and contracts
4.32.3 Preconditions
Claims data with provider information, user has provider network role
4.32.4 Postconditions
Provider utilization report generated with patterns and concentration metrics
4.32.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| UTL-PROVIDER-PATTERNS-TC-001 | Verify most utilized providers identification | High |
| UTL-PROVIDER-PATTERNS-TC-002 | Verify provider market share calculation | High |
| UTL-PROVIDER-PATTERNS-TC-003 | Verify network vs non-network utilization | High |
| UTL-PROVIDER-PATTERNS-TC-004 | Verify provider concentration analysis | High |
| UTL-PROVIDER-PATTERNS-TC-005 | Verify geographic coverage gaps identification | High |
| UTL-PROVIDER-PATTERNS-TC-006 | Verify specialty utilization patterns | Medium |
4.33 Ft Rpt Utl Cost Efficiency
4.33.1 Priority
Must Have
4.33.2 User Story
As a finance manager, I want to analyze cost efficiency of utilization so that I can identify cost optimization opportunities
4.33.3 Preconditions
Claims cost data, user has finance/utilization management role
4.33.4 Postconditions
Cost efficiency report generated with opportunities for optimization
4.33.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| UTL-COST-EFFICIENCY-TC-001 | Verify cost per service type calculation | High |
| UTL-COST-EFFICIENCY-TC-002 | Verify cost per member per month (PMPM) | High |
| UTL-COST-EFFICIENCY-TC-003 | Verify cost variation by provider | High |
| UTL-COST-EFFICIENCY-TC-004 | Verify cost variation by region | High |
| UTL-COST-EFFICIENCY-TC-005 | Verify preventable costs identification | High |
| UTL-COST-EFFICIENCY-TC-006 | Verify generic vs brand drug utilization cost impact | High |
4.34 Ft Rpt Prv Performance
4.34.1 Priority
Must Have
4.34.2 User Story
As a provider network manager, I want to analyze provider performance metrics so that I can identify high-performing and underperforming providers
4.34.3 Preconditions
Provider performance data available, user has provider network role
4.34.4 Postconditions
Provider performance report generated with quality and efficiency metrics
4.34.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| PRV-PERFORMANCE-TC-001 | Verify provider quality scores display | High |
| PRV-PERFORMANCE-TC-002 | Verify claims approval rate by provider | High |
| PRV-PERFORMANCE-TC-003 | Verify average cost per visit by provider | High |
| PRV-PERFORMANCE-TC-004 | Verify member satisfaction scores | High |
| PRV-PERFORMANCE-TC-005 | Verify readmission rates tracking | Medium |
| PRV-PERFORMANCE-TC-006 | Verify adherence to protocols assessment | Medium |
4.35 Ft Rpt Prv Cost Analysis
4.35.1 Priority
Must Have
4.35.2 User Story
As a provider network manager, I want to analyze provider costs and efficiency so that I can negotiate contracts and optimize network
4.35.3 Preconditions
Provider cost data available, user has provider network role
4.35.4 Postconditions
Provider cost analysis report generated with efficiency benchmarks
4.35.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| PRV-COST-ANALYSIS-TC-001 | Verify cost per provider vs network average | High |
| PRV-COST-ANALYSIS-TC-002 | Verify fee schedule compliance tracking | High |
| PRV-COST-ANALYSIS-TC-003 | Verify outlier identification (high-cost providers) | High |
| PRV-COST-ANALYSIS-TC-004 | Verify capitation vs fee-for-service cost comparison | High |
| PRV-COST-ANALYSIS-TC-005 | Verify cost trend by provider over time | High |
| PRV-COST-ANALYSIS-TC-006 | Verify cost efficiency ranking | High |
4.36 Ft Rpt Prv Network Coverage
4.36.1 Priority
Must Have
4.36.2 User Story
As a provider network manager, I want to analyze provider network coverage so that I can identify gaps and expansion opportunities
4.36.3 Preconditions
Provider location data, member location data, user has provider network role
4.36.4 Postconditions
Network coverage report generated with gap analysis and recommendations
4.36.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| PRV-NETWORK-COVERAGE-TC-001 | Verify provider density by region | High |
| PRV-NETWORK-COVERAGE-TC-002 | Verify provider density by specialty | High |
| PRV-NETWORK-COVERAGE-TC-003 | Verify member-to-provider ratio calculation | High |
| PRV-NETWORK-COVERAGE-TC-004 | Verify geographic coverage maps displayed | High |
| PRV-NETWORK-COVERAGE-TC-005 | Verify network adequacy assessment | High |
| PRV-NETWORK-COVERAGE-TC-006 | Verify specialty coverage gaps identification | High |
4.37 Ft Rpt Well Participation
4.37.1 Priority
Must Have
4.37.2 User Story
As a wellness manager, I want to analyze wellness program participation so that I can measure engagement and identify improvement areas
4.37.3 Preconditions
Wellness participation data available, user has wellness role
4.37.4 Postconditions
Wellness participation report generated with engagement metrics and barriers
4.37.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| WELL-PARTICIPATION-TC-001 | Verify participation rate by program | High |
| WELL-PARTICIPATION-TC-002 | Verify demographic breakdown of participants | High |
| WELL-PARTICIPATION-TC-003 | Verify repeat participation tracking | High |
| WELL-PARTICIPATION-TC-004 | Verify engagement trends over time | High |
| WELL-PARTICIPATION-TC-005 | Verify barriers to participation analysis | Medium |
| WELL-PARTICIPATION-TC-006 | Verify participation vs non-participation comparison | High |
4.38 Ft Rpt Well Outcomes
4.38.1 Priority
Must Have
4.38.2 User Story
As a wellness manager, I want to analyze wellness program health outcomes so that I can measure program effectiveness
4.38.3 Preconditions
Wellness outcomes data available, user has wellness role
4.38.4 Postconditions
Wellness outcomes report generated with health improvements and effectiveness metrics
4.38.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| WELL-OUTCOMES-TC-001 | Verify biometric improvements tracking (weight, BP, cholesterol, etc.) | High |
| WELL-OUTCOMES-TC-002 | Verify risk score changes analysis | High |
| WELL-OUTCOMES-TC-003 | Verify chronic disease management outcomes | High |
| WELL-OUTCOMES-TC-004 | Verify preventive care utilization increase | High |
| WELL-OUTCOMES-TC-005 | Verify lifestyle behavior changes tracking | Medium |
| WELL-OUTCOMES-TC-006 | Verify before/after comparison for participants | High |
4.39 Ft Rpt Well Roi
4.39.1 Priority
Must Have
4.39.2 User Story
As a wellness manager, I want to calculate wellness program ROI so that I can justify investment in wellness programs
4.39.3 Preconditions
Wellness program costs and claims data available, user has wellness/finance role
4.39.4 Postconditions
Wellness ROI report generated with cost-benefit analysis
4.39.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| WELL-ROI-TC-001 | Verify program costs calculation | High |
| WELL-ROI-TC-002 | Verify savings calculation (reduced claims) | High |
| WELL-ROI-TC-003 | Verify cost per participant calculation | High |
| WELL-ROI-TC-004 | Verify healthcare cost trend comparison (participants vs non-participants) | High |
| WELL-ROI-TC-005 | Verify productivity gains estimation | Medium |
| WELL-ROI-TC-006 | Verify engagement ROI calculation | Medium |
| WELL-ROI-TC-007 | Verify ROI trend over time | High |
4.40 Ft Rpt Custom Builder
4.40.1 Priority
Must Have
4.40.2 User Story
As a business analyst, I want to build custom reports using drag-and-drop interface so that I can create ad-hoc reports without IT assistance
4.40.3 Preconditions
User authenticated with report builder access, data sources configured
4.40.4 Postconditions
Custom report built and executed successfully
4.40.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CUSTOM-BUILDER-TC-001 | Verify drag-and-drop fields to report canvas | High |
| CUSTOM-BUILDER-TC-002 | Verify filter configuration (conditions, operators) | High |
| CUSTOM-BUILDER-TC-003 | Verify grouping configuration | High |
| CUSTOM-BUILDER-TC-004 | Verify sorting configuration | High |
| CUSTOM-BUILDER-TC-005 | Verify data sources available (claims, members, policies, providers, payments, wellness) | High |
| CUSTOM-BUILDER-TC-006 | Verify preview before generating full report | High |
| CUSTOM-BUILDER-TC-007 | Verify report execution and display | High |
4.41 Ft Rpt Custom Save Share
4.41.1 Priority
Must Have
4.41.2 User Story
As a business analyst, I want to save and share custom reports so that I can reuse reports and collaborate with team
4.41.3 Preconditions
Custom report created, user authenticated
4.41.4 Postconditions
Report saved and shared with specified users/roles
4.41.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CUSTOM-SAVE-SHARE-TC-001 | Verify save report definition | High |
| CUSTOM-SAVE-SHARE-TC-002 | Verify name and categorize report | High |
| CUSTOM-SAVE-SHARE-TC-003 | Verify share with users/roles | High |
| CUSTOM-SAVE-SHARE-TC-004 | Verify version history tracking | Medium |
| CUSTOM-SAVE-SHARE-TC-005 | Verify clone and modify existing reports | High |
| CUSTOM-SAVE-SHARE-TC-006 | Verify access control on shared reports | High |
4.42 Ft Rpt Custom Visualizations
4.42.1 Priority
Must Have
4.42.2 User Story
As a business analyst, I want to add visualizations to custom reports so that I can present data in charts and graphs
4.42.3 Preconditions
Custom report with data, user authenticated
4.42.4 Postconditions
Visualizations added to report and displayed correctly
4.42.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CUSTOM-VISUALIZATIONS-TC-001 | Verify chart types available (bar, line, pie, scatter, heatmap) | High |
| CUSTOM-VISUALIZATIONS-TC-002 | Verify customize colors | Medium |
| CUSTOM-VISUALIZATIONS-TC-003 | Verify customize labels and legends | Medium |
| CUSTOM-VISUALIZATIONS-TC-004 | Verify multiple visualizations per report | High |
| CUSTOM-VISUALIZATIONS-TC-005 | Verify export charts as images | Medium |
| CUSTOM-VISUALIZATIONS-TC-006 | Verify chart data linked to report data | High |
4.43 Ft Rpt Custom Calculations
4.43.1 Priority
Must Have
4.43.2 User Story
As a business analyst, I want to add calculated fields to custom reports so that I can perform custom analytics
4.43.3 Preconditions
Custom report builder open, user authenticated
4.43.4 Postconditions
Calculated fields added to report and computed correctly
4.43.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| CUSTOM-CALCULATIONS-TC-001 | Verify formula builder with functions (sum, avg, count, percentage, ratios) | High |
| CUSTOM-CALCULATIONS-TC-002 | Verify aggregations (group by) support | High |
| CUSTOM-CALCULATIONS-TC-003 | Verify conditional calculations (IF/THEN) | High |
| CUSTOM-CALCULATIONS-TC-004 | Verify date calculations (date diff, date add, etc.) | High |
| CUSTOM-CALCULATIONS-TC-005 | Verify calculation validation and error handling | High |
| CUSTOM-CALCULATIONS-TC-006 | Verify calculated field naming and reuse | Medium |
4.44 Ft Rpt Schedule Config
4.44.1 Priority
Must Have
4.44.2 User Story
As a report administrator, I want to schedule reports for automated generation so that I can receive regular reports without manual effort
4.44.3 Preconditions
Report defined, user has scheduling permissions
4.44.4 Postconditions
Report schedule configured and activated
4.44.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SCHEDULE-CONFIG-TC-001 | Verify schedule frequency options (daily, weekly, monthly, quarterly, annual) | High |
| SCHEDULE-CONFIG-TC-002 | Verify time of day configuration | High |
| SCHEDULE-CONFIG-TC-003 | Verify day of week/month configuration | High |
| SCHEDULE-CONFIG-TC-004 | Verify effective date range configuration | Medium |
| SCHEDULE-CONFIG-TC-005 | Verify expiration date configuration | Medium |
| SCHEDULE-CONFIG-TC-006 | Verify schedule activation/deactivation | High |
4.45 Ft Rpt Schedule Distribution
4.45.1 Priority
Must Have
4.45.2 User Story
As a report administrator, I want to configure automated report distribution so that I can deliver reports to stakeholders automatically
4.45.3 Preconditions
Report scheduled, user has distribution permissions
4.45.4 Postconditions
Distribution configured and reports delivered automatically
4.45.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SCHEDULE-DISTRIBUTION-TC-001 | Verify email distribution list configuration | High |
| SCHEDULE-DISTRIBUTION-TC-002 | Verify attachment format selection (PDF, Excel) | High |
| SCHEDULE-DISTRIBUTION-TC-003 | Verify report portal notification option | Medium |
| SCHEDULE-DISTRIBUTION-TC-004 | Verify FTP/SFTP delivery option | Medium |
| SCHEDULE-DISTRIBUTION-TC-005 | Verify distribution log maintained | High |
| SCHEDULE-DISTRIBUTION-TC-006 | Verify email delivery with proper formatting | High |
4.46 Ft Rpt Schedule History
4.46.1 Priority
Must Have
4.46.2 User Story
As a report administrator, I want to view history of scheduled report executions so that I can track delivery and troubleshoot issues
4.46.3 Preconditions
Scheduled reports exist, user has admin access
4.46.4 Postconditions
Execution history displayed with status and details
4.46.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| SCHEDULE-HISTORY-TC-001 | Verify execution log shows success/failure | High |
| SCHEDULE-HISTORY-TC-002 | Verify generated report archive accessible | High |
| SCHEDULE-HISTORY-TC-003 | Verify download previous reports | High |
| SCHEDULE-HISTORY-TC-004 | Verify error details available for failed executions | High |
| SCHEDULE-HISTORY-TC-005 | Verify retry failed reports capability | Medium |
| SCHEDULE-HISTORY-TC-006 | Verify execution time and duration tracked | Medium |
4.47 Ft Rpt Export Excel
4.47.1 Priority
Must Have
4.47.2 User Story
As a business user, I want to export reports to Excel format so that I can perform additional analysis in spreadsheets
4.47.3 Preconditions
Report generated, user authenticated
4.47.4 Postconditions
Report exported to Excel file successfully
4.47.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXPORT-EXCEL-TC-001 | Verify multi-sheet workbooks supported | High |
| EXPORT-EXCEL-TC-002 | Verify formatted cells preserved | Medium |
| EXPORT-EXCEL-TC-003 | Verify formulas included where applicable | Medium |
| EXPORT-EXCEL-TC-004 | Verify charts included in export | Medium |
| EXPORT-EXCEL-TC-005 | Verify styling preserved (colors, fonts, borders) | Medium |
| EXPORT-EXCEL-TC-006 | Verify large dataset support (100K+ rows) | High |
| EXPORT-EXCEL-TC-007 | Verify file download successful | High |
4.48 Ft Rpt Export Pdf
4.48.1 Priority
Must Have
4.48.2 User Story
As a business user, I want to export reports to PDF format so that I can share professional formatted reports
4.48.3 Preconditions
Report generated, user authenticated
4.48.4 Postconditions
Report exported to PDF file successfully
4.48.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXPORT-PDF-TC-001 | Verify professional layout applied | High |
| EXPORT-PDF-TC-002 | Verify company branding included | Medium |
| EXPORT-PDF-TC-003 | Verify page headers/footers present | Medium |
| EXPORT-PDF-TC-004 | Verify table of contents for multi-section reports | Medium |
| EXPORT-PDF-TC-005 | Verify charts and visualizations rendered correctly | High |
| EXPORT-PDF-TC-006 | Verify print-ready format | Medium |
| EXPORT-PDF-TC-007 | Verify file download successful | High |
4.49 Ft Rpt Export Csv
4.49.1 Priority
Must Have
4.49.2 User Story
As a data analyst, I want to export reports to CSV format so that I can import data into other systems
4.49.3 Preconditions
Report generated, user authenticated
4.49.4 Postconditions
Report exported to CSV file successfully
4.49.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXPORT-CSV-TC-001 | Verify configurable delimiter (comma, semicolon, tab) | Medium |
| EXPORT-CSV-TC-002 | Verify UTF-8 encoding | High |
| EXPORT-CSV-TC-003 | Verify header row option | High |
| EXPORT-CSV-TC-004 | Verify large file support | High |
| EXPORT-CSV-TC-005 | Verify streaming export for big datasets | High |
| EXPORT-CSV-TC-006 | Verify file download successful | High |
4.50 Ft Rpt Export Json
4.50.1 Priority
Must Have
4.50.2 User Story
As a developer, I want to export reports to JSON format so that I can integrate with APIs and applications
4.50.3 Preconditions
Report generated, user has API access
4.50.4 Postconditions
Report exported to JSON format successfully
4.50.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| EXPORT-JSON-TC-001 | Verify structured JSON schema | High |
| EXPORT-JSON-TC-002 | Verify nested objects support | High |
| EXPORT-JSON-TC-003 | Verify metadata included (report name, date, parameters) | Medium |
| EXPORT-JSON-TC-004 | Verify pagination for large datasets | High |
| EXPORT-JSON-TC-005 | Verify API endpoint for exports available | High |
| EXPORT-JSON-TC-006 | Verify JSON validation and proper formatting | High |
4.51 Ft Rpt Reg Tira Returns
4.51.1 Priority
Must Have
4.51.2 User Story
As a compliance officer, I want to generate TIRA statutory returns so that I can comply with regulatory requirements
4.51.3 Preconditions
Financial and operational data available, user has compliance role
4.51.4 Postconditions
TIRA returns generated in prescribed format
4.51.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| REG-TIRA-RETURNS-TC-001 | Verify TIRA quarterly returns generation | High |
| REG-TIRA-RETURNS-TC-002 | Verify TIRA annual returns generation | High |
| REG-TIRA-RETURNS-TC-003 | Verify prescribed format compliance | High |
| REG-TIRA-RETURNS-TC-004 | Verify data validation before submission | High |
| REG-TIRA-RETURNS-TC-005 | Verify audit trail maintained | High |
| REG-TIRA-RETURNS-TC-006 | Verify electronic submission format | High |
| REG-TIRA-RETURNS-TC-007 | Verify archival of submitted returns | Medium |
4.52 Ft Rpt Reg Tax Returns
4.52.1 Priority
Must Have
4.52.2 User Story
As a tax officer, I want to generate tax returns and supporting documents so that I can comply with tax obligations
4.52.3 Preconditions
Financial data available, user has tax/finance role
4.52.4 Postconditions
Tax returns generated in prescribed format
4.52.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| REG-TAX-RETURNS-TC-001 | Verify VAT returns generation | High |
| REG-TAX-RETURNS-TC-002 | Verify income tax supporting schedules | High |
| REG-TAX-RETURNS-TC-003 | Verify withholding tax reports | High |
| REG-TAX-RETURNS-TC-004 | Verify prescribed format compliance | High |
| REG-TAX-RETURNS-TC-005 | Verify validation before submission | High |
| REG-TAX-RETURNS-TC-006 | Verify archival of tax returns | Medium |
4.53 Ft Rpt Reg Statutory Accounts
4.53.1 Priority
Must Have
4.53.2 User Story
As a CFO, I want to generate statutory financial statements so that I can meet regulatory and governance requirements
4.53.3 Preconditions
Financial data available, user has CFO/finance role
4.53.4 Postconditions
Statutory accounts generated in compliance with IFRS 17
4.53.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| REG-STATUTORY-ACCOUNTS-TC-001 | Verify balance sheet generation | High |
| REG-STATUTORY-ACCOUNTS-TC-002 | Verify income statement generation | High |
| REG-STATUTORY-ACCOUNTS-TC-003 | Verify cash flow statement generation | High |
| REG-STATUTORY-ACCOUNTS-TC-004 | Verify notes to accounts | High |
| REG-STATUTORY-ACCOUNTS-TC-005 | Verify IFRS 17 compliance | High |
| REG-STATUTORY-ACCOUNTS-TC-006 | Verify trial balance support | High |
| REG-STATUTORY-ACCOUNTS-TC-007 | Verify audit trail maintained | High |
4.54 Ft Rpt Reg Compliance
4.54.1 Priority
Must Have
4.54.2 User Story
As a compliance officer, I want to generate compliance monitoring reports so that I can demonstrate regulatory compliance
4.54.3 Preconditions
Compliance data available, user has compliance role
4.54.4 Postconditions
Compliance reports generated with monitoring metrics
4.54.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| REG-COMPLIANCE-TC-001 | Verify solvency margin calculations | High |
| REG-COMPLIANCE-TC-002 | Verify investment compliance reports | High |
| REG-COMPLIANCE-TC-003 | Verify governance compliance reports | High |
| REG-COMPLIANCE-TC-004 | Verify complaint registers generation | High |
| REG-COMPLIANCE-TC-005 | Verify required disclosures included | High |
| REG-COMPLIANCE-TC-006 | Verify compliance tracking over time | Medium |
4.55 Ft Rpt Adhoc Query Builder
4.55.1 Priority
Must Have
4.55.2 User Story
As a business analyst, I want to build ad-hoc queries using query builder so that I can answer specific business questions quickly
4.55.3 Preconditions
User authenticated with query builder access
4.55.4 Postconditions
Ad-hoc query executed and results displayed
4.55.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| ADHOC-QUERY-BUILDER-TC-001 | Verify visual query builder interface | High |
| ADHOC-QUERY-BUILDER-TC-002 | Verify filter conditions (AND/OR logic) | High |
| ADHOC-QUERY-BUILDER-TC-003 | Verify sorting configuration | High |
| ADHOC-QUERY-BUILDER-TC-004 | Verify aggregations support | High |
| ADHOC-QUERY-BUILDER-TC-005 | Verify limit results option | Medium |
| ADHOC-QUERY-BUILDER-TC-006 | Verify save queries for reuse | High |
4.56 Ft Rpt Adhoc Quick Filters
4.56.1 Priority
Must Have
4.56.2 User Story
As a report user, I want to apply quick filters to existing reports so that I can slice data by different dimensions
4.56.3 Preconditions
Report displayed, user authenticated
4.56.4 Postconditions
Quick filters applied and report updated
4.56.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| ADHOC-QUICK-FILTERS-TC-001 | Verify common filters available (date range, product, region, provider, status) | High |
| ADHOC-QUICK-FILTERS-TC-002 | Verify filter persistence across page refresh | Medium |
| ADHOC-QUICK-FILTERS-TC-003 | Verify clear all filters option | High |
| ADHOC-QUICK-FILTERS-TC-004 | Verify filter presets for common scenarios | Medium |
| ADHOC-QUICK-FILTERS-TC-005 | Verify multiple filters can be applied simultaneously | High |
| ADHOC-QUICK-FILTERS-TC-006 | Verify report updates dynamically on filter change | High |
4.57 Ft Rpt Adhoc Data Preview
4.57.1 Priority
Must Have
4.57.2 User Story
As a business analyst, I want to preview data before generating full report so that I can verify query results and save time
4.57.3 Preconditions
Query or report configured, user authenticated
4.57.4 Postconditions
Data preview displayed with sample results
4.57.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| ADHOC-DATA-PREVIEW-TC-001 | Verify sample data preview (first 100 rows) | High |
| ADHOC-DATA-PREVIEW-TC-002 | Verify record count displayed | High |
| ADHOC-DATA-PREVIEW-TC-003 | Verify performance estimation shown | Medium |
| ADHOC-DATA-PREVIEW-TC-004 | Verify modify query before full execution | High |
| ADHOC-DATA-PREVIEW-TC-005 | Verify preview loads quickly (< 2 seconds) | High |
| ADHOC-DATA-PREVIEW-TC-006 | Verify proceed to full report generation | High |
4.58 Ft Rpt Mgmt Catalog
4.58.1 Priority
Must Have
4.58.2 User Story
As a report user, I want to browse report catalog organized by category so that I can find available reports easily
4.58.3 Preconditions
User authenticated, reports exist in catalog
4.58.4 Postconditions
Report catalog displayed with categorization and search
4.58.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MGMT-CATALOG-TC-001 | Verify categories displayed (executive, operational, financial, claims, membership, sales, provider, wellness, regulatory) | High |
| MGMT-CATALOG-TC-002 | Verify search by name/description | High |
| MGMT-CATALOG-TC-003 | Verify favorites functionality | Medium |
| MGMT-CATALOG-TC-004 | Verify recently used reports shown | Medium |
| MGMT-CATALOG-TC-005 | Verify report preview/description available | Medium |
| MGMT-CATALOG-TC-006 | Verify access to authorized reports only | High |
4.59 Ft Rpt Mgmt Access Control
4.59.1 Priority
Must Have
4.59.2 User Story
As a report administrator, I want to control access to reports based on roles so that I can ensure data security and privacy
4.59.3 Preconditions
Reports defined, roles configured, user has admin access
4.59.4 Postconditions
Access control configured and enforced
4.59.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MGMT-ACCESS-CONTROL-TC-001 | Verify role-based access (executive, manager, analyst, viewer) | High |
| MGMT-ACCESS-CONTROL-TC-002 | Verify report permissions (view, edit, share, export) | High |
| MGMT-ACCESS-CONTROL-TC-003 | Verify data-level security (filter by user's region/department) | High |
| MGMT-ACCESS-CONTROL-TC-004 | Verify unauthorized access blocked | High |
| MGMT-ACCESS-CONTROL-TC-005 | Verify permission inheritance from roles | High |
| MGMT-ACCESS-CONTROL-TC-006 | Verify override permissions for specific users | Medium |
4.60 Ft Rpt Mgmt Audit Trail
4.60.1 Priority
Must Have
4.60.2 User Story
As a compliance officer, I want to maintain audit trail of report access and generation so that I can track usage and ensure compliance
4.60.3 Preconditions
Reports accessed/generated, user has compliance role
4.60.4 Postconditions
Audit trail maintained with comprehensive logging
4.60.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MGMT-AUDIT-TRAIL-TC-001 | Verify log who accessed which report | High |
| MGMT-AUDIT-TRAIL-TC-002 | Verify log when report accessed | High |
| MGMT-AUDIT-TRAIL-TC-003 | Verify log parameters used for report generation | High |
| MGMT-AUDIT-TRAIL-TC-004 | Verify log export actions | High |
| MGMT-AUDIT-TRAIL-TC-005 | Verify log modifications to report definitions | High |
| MGMT-AUDIT-TRAIL-TC-006 | Verify retention period 7 years | High |
| MGMT-AUDIT-TRAIL-TC-007 | Verify audit log cannot be modified or deleted | High |
4.61 Ft Rpt Mgmt Versioning
4.61.1 Priority
Must Have
4.61.2 User Story
As a report administrator, I want to manage report versions so that I can track changes and rollback if needed
4.61.3 Preconditions
Reports exist, user has admin access
4.61.4 Postconditions
Report versioning enabled with history and rollback
4.61.5 Test Cases
| Id | Description | Weight |
|---|---|---|
| MGMT-VERSIONING-TC-001 | Verify version history for report definitions | High |
| MGMT-VERSIONING-TC-002 | Verify compare versions functionality | Medium |
| MGMT-VERSIONING-TC-003 | Verify rollback to previous version | High |
| MGMT-VERSIONING-TC-004 | Verify change notes captured for each version | Medium |
| MGMT-VERSIONING-TC-005 | Verify archive old versions | Medium |
| MGMT-VERSIONING-TC-006 | Verify version metadata (who, when, what changed) | High |