In business and in life, there is no way to predict a catastrophic loss. The best we can do is taking proper precautions to ensure minimal damage should something catastrophic happen. When it comes employer-funded healthcare, Managing General Underwriters that provide Medical Stop Loss coverage can help minimalize damage and protect employers in a medical insurance marketplace that is constantly changing and evolving.
As independent underwriters, gaining and keep the trust of our clients is crucial. Prodigy offers unique solutions that direct underwriters generally do not. When choosing to work with Prodigy as a self-funded employer with more than 51 employees, you get flexibility and benefits that you wouldn’t otherwise get if you choose to do business with a direct writer. In addition, you get a personal touch, and claims payment policies that we view as a cut above our competition.
Outsourcing Claim Department
While the Affordable Care Act has helped many Americans gain access to healthcare, it’s not without its issues. Issues such as inappropriate billing have unfortunately become more and more commonplace since the implementation of the Affordable Care Act, and has hurt the bottom line of many employers that might not have even been aware such fraudulent actions were taking place. While no one can completely guarantee that fraudulent actions such as inappropriate billing, a stop loss insurance plan with Prodigy protects our clients on a daily basis from being taken advantage of.
Simplifying Your Self-Funded Health Insurance
Just like legalese, medical insurance policies can be difficult to understand. Insurance providers do add value to their products through policy enhancements like monthly accommodation, specific advance, rate caps, terminal liability, and so on. These enhancements can be valuable to the employer and customer, but almost always add extra costs that might sometimes be hidden to the policyholder. At Prodigy, our stop loss-underwriting experts are always straightforward, upfront and honest about what policy enhancements can do for your self-funded healthcare plans. We won’t add any unnecessary frills just for the sake of upselling.
Different Types of Medical Stop-Loss Insurance
As a self-funded employer, you know that you need some kind of medical stop loss insurance. However, which stop loss policy is right for you and your business needs?
Specific Stop Loss – this type of coverage is also referred to as individual stop loss, and it protects you the employer in the event of a high claim coming from any particular individual. This form of coverage is beneficial in protecting you from exceptionally high single claims.
Aggregate Stop Loss – this form of medical stop loss coverage is based on the amount of total coverage that an employer pays. The total amount of all claims are aggregated and then reimbursed to the employer.
Generally, our clients opt to purchase both of these forms of stop loss coverage, protecting themselves from abnormally high single claims and frequent claims as well. Feel free to ask one of our representatives which type is best for you, or if they recommend both.
If you have self-funded health insurance plans that you provide for your employees, you know that doing so comes with inherent risks. A medical stop-loss policy with Prodigy will help you minimize these risks by providing financial coverage and security, which will give you peace of mind as an employer.
If you have any questions on how healthcare underwriters can help your business, don’t hesitate to contact us.