Chapter 35: Insurance and Government Systems -- Further Reading

Books

"Property and Casualty Insurance Accounting" by the Insurance Accounting and Systems Association (IASA) This is the standard reference for insurance accounting principles, covering premium revenue recognition, loss reserve estimation, reinsurance accounting, and statutory financial reporting. Understanding these accounting concepts is essential for any COBOL programmer maintaining policy administration or claims processing systems. Available through IASA and insurance industry booksellers.

"Life Insurance Accounting" by Edwin L. Bartleson and James J. Olsen For programmers working on life insurance systems, this text covers the unique accounting requirements of life insurance: policy reserve calculations, deferred acquisition costs, surrender values, and the distinct statutory accounting principles that differ from GAAP. Available through insurance industry publishers and technical libraries.

"Social Security: A Documentary History" by Sylvester J. Schieber This historical reference provides context for how Social Security systems evolved and why the benefit calculation formulas (AIME, PIA, bend points) are structured the way they are. Understanding the legislative history helps programmers make sense of the complex rules they implement. Available through major online booksellers.

Online Resources

National Association of Insurance Commissioners (NAIC) -- Annual Statement Instructions The NAIC publishes the detailed instructions and formats for the statutory annual statement that every insurance company must file with state regulators. COBOL programs that generate regulatory reports must produce output conforming to these specifications. The instructions cover every schedule, exhibit, and interrogatory in the statement blank. Available through the NAIC website.

Social Security Administration -- Program Operations Manual System (POMS) POMS is the primary source of policy and procedural instructions for Social Security programs. It contains the detailed rules for benefit computation, eligibility determination, earnings records, and payment processing that COBOL programs implement. Available on the Social Security Administration website.

Centers for Medicare and Medicaid Services (CMS) -- Medicaid Eligibility Policy CMS publishes the federal Medicaid eligibility rules that state systems must implement. The documentation covers Modified Adjusted Gross Income (MAGI) methodology, categorical eligibility, asset tests, and the complex interaction between federal floor requirements and state options. Available on the Medicaid.gov website.

HIPAA X12 EDI Transaction Set Standards The Health Insurance Portability and Accountability Act mandates specific EDI transaction formats for health insurance claims (837), payment remittance (835), eligibility inquiry and response (270/271), and other transactions. COBOL programs that process health insurance data must parse and generate these formats. Implementation guides are available through the Accredited Standards Committee X12.

IBM Documentation

IBM Redbook: "Insurance Application Architecture on z/OS" This Redbook covers the architecture of insurance systems on IBM mainframes, including policy administration, claims processing, and regulatory reporting. It discusses batch processing patterns, VSAM file design for insurance data, and integration between mainframe COBOL systems and modern front-end applications. Search for this title on the IBM Redbooks website.

IBM Redbook: "Modernizing Government Systems" This publication addresses the challenges of maintaining and modernizing large-scale government COBOL systems, including the Social Security Administration and IRS systems. It covers incremental modernization strategies, API enablement of legacy COBOL programs, and the role of z/OS Connect in exposing mainframe services to modern interfaces. Available on the IBM Redbooks website.

Regulatory References

IRS Publication 17 -- Your Federal Income Tax While written for taxpayers, Publication 17 documents the tax computation rules, deduction limits, credit calculations, and phase-out thresholds that IRS COBOL programs implement. Programmers maintaining tax processing systems refer to Publication 17 and the Internal Revenue Code to verify that their programs correctly implement current-year tax law. Available on the IRS website.

State Insurance Department Regulations -- Varies by State Each state's insurance department publishes regulations governing premium rates, policy forms, claims handling requirements, and financial reporting. COBOL programs that support multi-state insurance operations must implement state-specific variations of these rules. Regulations are available through individual state insurance department websites and the NAIC's State Insurance Regulation database.

NIST Special Publication 800-53 -- Security Controls for Government Information Systems Government COBOL systems must comply with federal information security requirements defined in NIST SP 800-53. This publication covers access controls, audit and accountability, system integrity, and other security requirements that affect how government COBOL programs handle sensitive data. Available on the NIST website.