Tiered Split-Funding Specific Stop-Loss

Tiered Split-Funding Specific Stop-Loss- newly offered by more than one high quality carrier, this option offers employers substantial cost savings on their specific stop-loss, at the same time featuring less retention risk than traditional split funded products. With the tiered split-funded program, the carrier actually pays the corridor on the first claim or combination of claims. Only after the claim(s) exceed the deductible and the corridor, does the additional liability kick in. This concept combines the lower premiums associated with corridor products with an additional layer of protection for the client.

Risk Sharing Arrangements (TPA and Stop-Loss Carriers)- the first instances of this very interesting and effective concept that I am aware of we're used by the various Blue Cross/ Blue Shield organizations around the country. This is probably because they either own or have ownership roles in insurance companies in several states. What does this mean for the client? Depending on the specific state, it can mean streamlined underwriting (new and renewal), automatic, immediate reimbursement for specific stop-loss claims, no disclosures and, in my experience, very good rates.

My apologies, just must mention this. In my hotmail as I write and I saw an advertisement for this business, http://burlingtonsigns.com. That is 3rd ad I have seen from their website today! I think I am being stalked! Alright, I am going to resume what I was talking about 🙂

No Laser Options- as many of you can attest, there is no more unpleasant surprise than having a laser popped on you at renewal, especially when you are coming off a bad claims year to begin with. Some carriers do not laser on renewal and now other carriers and MGUs are now offering no laser options, usually at around a 10% premium.

Narrow Networks- to be fair, this is not an idea that originated in self-funded circles, but is actually the brainchild of insurance carriers vying for lower rates on the public exchanges. However, viable costs savings measures are quickly studied and adopted by employers trying to save money of their own. The concept is pretty simple; negotiating lower pricing with more restrictive managed care provider networks than those that we have been used to. The jury is still out as to the exact degree that they will affect pricing and how these smaller networks will accommodate the needs of employees, but initial data seems promising.

I do hope you enjoyed this. I should point out this had been requested by Martin at Aspen Oral Surgery. always appreciate ideas and comments.

Post Resources

http://www.thephoenixdesigngroup.com - Appreciate you for selflessly giving your practical knowledge.
http://the-bereavement-register.ca - Absolutely worth giving a read.

Posted in Business Service Post Date 11/30/2015






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