← PM Suite Requirements Traceability Matrix (RTM)

Enrollment & Claims Platform Modernization

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The second output of Collect Requirements (PMBOK® Guide §5.2), alongside the requirements documentation itself. Every baselined requirement is traced forward to the specification that realizes it, the method that verifies it, and the point at which it is accepted. Generated directly from the BRD and FSD, so the traces reflect those documents rather than a manual transcription of them.

59
Requirements baselined
52
Functional specifications
20/20
Functional reqs specified
100%
FR coverage
3
Open traceability gaps
What building this matrix found. Before the RTM existed, four functional requirements — FR-015, FR-018, FR-019 and FR-020 — were covered by the specification but not traced to it. The shared error-handling standard satisfied FR-015 without carrying specification identifiers at all. Constructing the trace forced those to be made explicit: the error-handling standard became FS-090–095, and three further specifications gained explicit references. That is the RTM doing the job it exists for — coverage you cannot demonstrate is coverage you cannot defend at a gate review.

01 How to Read This Matrix

Traceability runs downward through the requirement classes and outward to verification:

ClassTraces down toRealized inVerified by
BRStakeholder requirementsProgramme objectivesBenefits review at closeout
SRFunctional requirementsSolution behaviourUAT by the owning business function
FRFunctional specifications (FS)Configuration and integration buildSystem and integration testing
NFRArchitecture and infrastructure designTechnical designPerformance, security and DR testing
TRConversion, cutover and training plansTransition activityDry runs, parallel run, cutover rehearsal

Business requirements do not trace to functional specifications and are not expected to — they trace downward to stakeholder requirements and forward to the benefit case. Non-functional and transition requirements are largely realized outside the FSD, which is why their specification coverage is deliberately partial rather than a gap.

02 Coverage Summary

ClassRequirementsTraced to a specificationAssessment
BR80Expected — business requirements trace to objectives and the benefit case, not to specifications
SR75The remainder are satisfied through UAT scenarios rather than a discrete specification
FR2020Complete — every functional requirement has at least one specification
NFR124Realized in technical design; all verified under the Test Strategy
TR123Remainder realized in the conversion, cutover and training plans — see gaps below

BR Business Requirements

Why the change is being made — verified by Benefits review at closeout (CBA · Closeout Report).

IDRequirementPrioritySpecified by (FSD)
BR-001The organization must operate its enrollment and claims system of record on vendor-supported softwareMust— see note
BR-002Business operations must continue without interruption through and after cutoverMust— see note
BR-003All member, policy, provider/producer and historical claims data must be retained and remain accessibleMust— see note
BR-004Financial and regulatory reporting integrity must be preserved across the transitionMust— see note
BR-005The organization must not increase its ongoing run cost as a result of the upgradeShould— see note
BR-006Staff must be able to perform their work on the new platform without degradation in productivity after hypercareMust— see note
BR-007The legacy platform must be decommissioned once data retention obligations are satisfiedShould— see note
BR-008The program must not introduce new business capability that was not present in the legacy platformMust— see note

SR Stakeholder Requirements

What each stakeholder group needs — verified by UAT — business scenario execution (Test Strategy §09).

IDRequirementPrioritySpecified by (FSD)
SR-001Must be able to enroll, change and terminate member coverage with equivalent or fewer steps than the legacy platformMust— see note
SR-002Must be able to adjudicate, adjust and reverse claims with the same outcomes the legacy system produced for equivalent inputMustFS-030–034
SR-003Must receive complete and timely risk data for rating and policy issuanceMustFS-020–023
SR-004Must be able to reconcile premium, claims payment and commission to the cent across the transitionMustFS-010–014, FS-040–043, FS-060–064
SR-005Must be able to evidence control operation over financial reporting and payment pathsMustFS-060–064
SR-006Must be able to answer member and provider enquiries using converted history without recourse to the legacy systemMust— see note
SR-007Must be able to produce required state filings and regulatory reports on scheduleMustFS-050–054

FR Solution Requirements — Functional

What the solution must do — verified by System & integration testing (Test Strategy §04, §07).

IDRequirementPrioritySpecified by (FSD)
FR-001The solution shall administer member enrollment, changes, terminations and reinstatements, including retroactive effective datesMustFS-001–002
FR-002The solution shall maintain policy, group and benefit-plan configuration equivalent to current productionMustFS-003
FR-003The solution shall maintain provider and producer records, including hierarchy and effective datingMustFS-004
FR-004The solution shall adjudicate claims according to configured benefit rules, producing the same outcome as legacy for equivalent inputMustFS-005
FR-005The solution shall support claim adjustment, reversal and reprocessing with full audit trailMustFS-006
FR-006The solution shall support coordination of benefits where more than one coverage appliesMustFS-007
FR-007The solution shall maintain accumulators (deductible, out-of-pocket) accurately across the conversion boundaryMustFS-008
FR-008The solution shall provide role-based access aligned to current segregation-of-duties requirementsMustFS-009, FS-080
FR-009Billing: the solution shall transmit premium and adjustment data sufficient for invoicing on the current cycleMustFS-010–014
FR-010Underwriting: the solution shall provide risk and policy data required for rating and issuanceMustFS-020–023
FR-011Claims Administration: the solution shall exchange claim intake, status and adjudication data at current volumeMustFS-030–034
FR-012Commission Management: the solution shall provide the data required to calculate and trigger producer commission paymentsMustFS-040–043
FR-013Data Warehouse / Reporting: the solution shall deliver extracts sufficient for operational and regulatory reportingMustFS-050–054
FR-014Payment Processing: the solution shall initiate payment instructions and consume payment status with full reconciliationMustFS-060–064
FR-015Each interface shall handle failure conditions without silent data loss, with retry and exception reportingMustFS-090–095
FR-016Commission calculation behaviour shall follow the documented business decision where specification and legacy logic differMustFS-040–043
FR-017The solution shall produce all state-mandated filings and regulatory reports currently producedMustFS-050–054
FR-018The solution shall retain an auditable record of every financially material transactionMustFS-064, FS-082
FR-019The solution shall support enquiry against converted historical claims and enrollment dataMustFS-071
FR-020The solution shall provide operational reporting equivalent to legacy for daily business managementShouldFS-050

NFR Solution Requirements — Non-Functional

Qualities the solution must have — verified by Performance, security, DR testing (Test Strategy §10).

IDRequirementPrioritySpecified by (FSD)
NFR-001The solution shall sustain peak open-enrollment concurrency without degradation beyond agreed response targetsMust— see note
NFR-002Claims batch processing shall complete within the existing overnight window at current and projected volumeMustFS-034
NFR-003The solution shall meet or exceed the availability the legacy platform provided during business hoursMust— see note
NFR-004Backup, restore and failover shall be demonstrated by rehearsal before Go-LiveMust— see note
NFR-005PHI shall be encrypted in transit and at rest; access shall follow minimum-necessary principlesMustFS-080, FS-083
NFR-006The solution shall maintain HIPAA-compliant audit logging of access to protected health informationMustFS-082
NFR-007Controls over financial reporting and payment paths shall be testable and evidenced (SOX)MustFS-081
NFR-008Financial control totals shall reconcile exactly between source and targetMust— see note
NFR-009Data retention shall satisfy regulatory and contractual obligations for historical recordsMust— see note
NFR-010The platform version shall remain within vendor support for the defined horizonMust— see note
NFR-011Common enrollment and claims tasks shall require no more user steps than the legacy equivalentShould— see note
NFR-012Interfaces shall be documented to a standard permitting change without reverse engineeringShould— see note

TR Transition Requirements

Temporary capabilities needed only during the change — verified by Conversion dry runs, parallel run, cutover rehearsal (Test Strategy §05, §08).

IDRequirementPrioritySpecified by (FSD)
TR-001Historical member, policy, provider and claims data shall be converted with 100% record and control-total reconciliationMustFS-008, FS-070–072
TR-002Duplicate member records identified during conversion shall be resolved by documented rule, with every merge auditable and reversibleMustFS-074
TR-003Records that cannot be converted shall be quarantined, reported and owned — never silently droppedMustFS-073
TR-004Conversion shall be rehearsed at full volume prior to production executionMust— see note
TR-005Legacy and new platform shall be run in parallel on representative transactions, with variances explained before cutoverMust— see note
TR-006Conversion shall complete within the available cutover outage windowMust— see note
TR-007A tested rollback path shall exist up to the defined point of no returnMust— see note
TR-008Affected staff shall be trained and assessed as competent before cutoverMust— see note
TR-009Business process documentation shall be updated to reflect the new platform before Go-LiveMust— see note
TR-010Hypercare support shall be staffed at elevated levels for the defined period following cutoverMust— see note
TR-011Legacy platform access shall be retained read-only until data retention obligations are verified as satisfiedShould— see note
TR-012Members and providers shall be notified of any externally visible change in advanceShould— see note

03 Traceability Gaps — Now Closed

An RTM that reports complete coverage on a programme still in build is not being maintained. The three transition-requirement gaps this matrix recorded are now closed: each is owned by a maintained plan, cross-referenced below. Recording both the gap and its closure — rather than quietly deleting the gap once filled — is what lets a reviewer see that the matrix was worked, not decorated.

#Gap (as recorded)Affected requirementsNow owned byStatus
G-01No Data Conversion Plan artifact. Nine transition requirements name conversion behaviour that was specified nowhere as a maintained document; TR detail lived in the FSD and the Test StrategyTR-001 – TR-007Data Conversion Plan (T. McCormick)Closed
G-02No Cutover Plan artifact. Rollback, hypercare and cutover-window requirements had no single owning documentTR-006, TR-007, TR-010, TR-011, TR-012Cutover Plan (C. Tyrrell)Closed
G-03No Training Plan artifact. Training and process-documentation requirements were owned but not documentedTR-008, TR-009Training Plan (H. Osei / L. Bergström)Closed
All three gaps are closed against maintained documents. Every transition requirement TR-001 through TR-012 now traces to exactly one owning plan: TR-001–007 to the Data Conversion Plan, TR-006/007 runbook plus TR-010/011/012 to the Cutover Plan, and TR-008/009 to the Training Plan. The gaps were documentation gaps, not planning gaps — the WBS already contained the conversion, cutover and training work and the Test Strategy already specified verification; what was missing was the owning document a reviewer traces a transition requirement into, and now exists.

04 Maintenance & Governance

AspectRule
OwnerF. Jones — Lead Business Analyst
BaselineTracks the BRD baseline of 3 Nov 2026
Update triggerAny approved change to a requirement or specification, via the Change Control Log
Review pointEvery phase gate; coverage reported to the Steering Committee
GenerationRegenerated from the BRD and FSD rather than edited in place, so the matrix cannot drift from the documents it traces
Exit conditionAt Go-Live every Must requirement must show specification, verification and acceptance
Why it is generated rather than maintained by hand. A hand-maintained RTM degrades the moment a requirement changes and someone forgets to update a row — and it degrades silently, which is worse, because the matrix continues to assert coverage it no longer has. Deriving it from the source documents means the matrix is wrong only if the documents are wrong.