partial self-funding. Dale Bear, so welcome Dale. Thank you for joining us today. Hello Mark.
Good to be here. It's a great day. Yeah! Always technical difficulties with Google Hangout, but that's all right. It's wonderful to see you and I know we've been keeping you busy, and you've been busy, so thanks for taking your time.
Today specifically, I know that we wanted to speak a little bit to our clients and potential clients about reinsurance, and stop-loss insurance. So, maybe you can start if somebody is frankly pretty new to this whole concept, just tell us a little about what that is, and why somebody might use it. Well, you mentioned at the front that we're dealing with partial self-insured, and I call it that whether you're at, your deductible's $150,000 or your deductible's $2,000, so today, we're mainly going to talk about
the higher end of that, what most people would consider self-funding their group, but just so they understand, that would involve where they're paying the main claim up to a spec level, it's what we call a
spec, or a reinsurance level, where you're actually then buying insurance to cover the rest of that. There's three main pieces, I guess I would say, to self-funding.
You have your part of whatever you're gonna pick, that you're going to actually pay for
yourself. You have a TPA that handles that for you:
third party administrator. They're the ones that will actually do your claims, as far as your employees are concerned. They'll be considered the insurance company, so when it says, when you say something like under a fully insured plan, well Blue Cross paid, Well in this case whoever your TPA is will become that name, so as far as your folks are concerned, that will be your insurance company.
As part of that, they may use a PPO, a preferred provider organization, or someone that gets discounts. So you might also refer to your plan under that, and then finally we would have a reinsurance company, that we would buy for high risk, for catastrophic loss, and those would be seamless, behind the scenes, as far as reinsurance carriers. The only ones that would know about that would be yourselves within your contracts. So, on self-insured, you basically handle all your claims for anybody up to whatever deductible you choose that makes sense for you.
It's done by a third-party administrator if those claims go over a certain amount, over a certain deductible, then that reinsurance company kicks in and pays the remainder. And that's a very simplified picture of self-insured. So, let's talk about risk a little bit. So, when we're talking self-funded, obviously since these people are basically insuring themselves.
The stop-loss if somebody has a claim, they find out they have stage two cancer or something. It's going to be very expensive. At that point, this re-insurance is gonna kick in at $50,000, $100,000, whatever for that person, to take anything after that and pay it? Yeah, depends on the contract and how you do it. You can, you know there's even aggregating specs, or aggregating specifics.
But, that's getting a little complicated so let's just talk about, let's just take for example a large claim like you just mentioned, let's say it is someone that's gonna run a $400,000 bill. Let's just put it that way. And you're self insuring, as a company, you know, what's that gonna look like? And let's just use for an example, let's say you set it up and you have a third-party administrator. And you have a PPO network, let's just name one of them out there, let's say you use First Health.
Unless you use one of the major companies out there that's doing yourself funding, you have to use a rentable PPO, someone that will allow you to rent their network without them doing your claims also. So you're going to do something like a First Health, or like a PHCS, or a multi-plan, Med Cost, there are several units out there that are PPO networks. So you've selected that. What happens on it, and you've also selected your reinsurance, so let's say in this case your reinsurance is going to kick in at a $100,000 if you have a claim.
So this large claim comes through, the claim goes to your TPA, well it usally goes first to the PPO, to get repriced, to the network, they'll usually reprice the claim, then it goes to the TPA, the TPA will pay it. What they will do, the TPA does the technical work for you, so they send you the bill for the first $100,000. You're expected to pay that. That's one of the things with self-insuring, you have to make sure you have plenty of reserves and cash flow because like this, a big claim that gets in one month, you've gotta pay that $100,00 in one month, let alone the other claims that are coming in that month.
So
sometimes cash flow can be a problem. So you'll pay the $100,00. The TPA will actually verify that in fact this is a claim that hits the $100,00 spec. They send that to your reinsurance carrier, whoever that might be, say HTC or might be, Employers Reinsurance Corporation, etc.
There's a lot of, White Mountain Reinsurance, there's several, Lloyd's of London. They're all reinsurance companies. And they will look at it, they will verify that in fact it hits your spec, and then they will basically take over the claim at that point for the period of your contract. So once you hit the $100,000 spec with that employee, now they will pay 100% of the rest the claim for whatever the contract is and let's say it is an ACA compliant plan that you set up, which you have to because you're in a plan with a self-insured plan.
So it's unlimited, but the only limitation you'll have on it is the annual contract period. So let's say, let's keep it simple, let's say you have a January-December contract period. And this happens in July. So in July you have, the claim comes in several pieces, so let's say it comes in,
the first few hundred thousand.
So you paid 100, reinsurance carriers now
paid 100. They will continue paying any claim on that employee until December 31st when you renew. That brings up some other interesting things with self-insured that you have to make sure that you have done right in the area of contracts. You want to get in the contracts now? Of how reinsurance contracts, etc? Is that something you'd be interested in? That we might have to hold for another
day.
And/or have people call you obviously, because I know this is a vastly complicated field, and I'm sure you would tell people that they shouldn't be trying to necessarily do this on their own. I think that... Well some people fear large claims like we just talked about. But, in reality, one large claim isn't too much of a problem.
If it's an ongoing claim, it can be a problem on renewing your reinsurance In some cases the reinsurance may laser out a particular employee of yours. For instance, let's take the same example
we had. Let's say this is an ongoing cancer case and it's not going to end on January 1st. If you haven't been careful with the reinsurance company that you've shopped for, they may come back to you and say, okay, next year we will renew for January through December, at this rate.
They give you a rate that's close maybe to where you had before, maybe a little up, depends on the rest of your claims. But then they say on this specific employee, we're going to laser him out. And that may mean that they say you have to stay in the first 300,000 on him. Then we will kick in after that.
That's called lasering and they can do that, and they do do that. But part of the thing
when you set it up, you want to be careful that you get a company that either guarantees you that they won't laser, and sometimes that has to do with the size of your group.. Frankly, you may not be able to do that, so you may just have to be aware of that. The problem with laser renew is you're stuck, because at that point when the claim is happening, you can't go anywhere else.
You can't go to a fully insured carrier at that point. You can't go to another reinsurance company. So if you do get lasered with a claim, in that example then you're going to have to pay the bill, and if they say we'll laser to 400, You just hope that the person is not going to have that much treatment the next year. Because what can happen is, you'll pay
the first $400,00 of claims.
Let's say he has half a million in claims the
next year. You will pay 400, then the reinsurance carrier will kick in and pay an additional 100. And that will make your self-insured health plan look pretty bad. It can be very high.
That's why we also get in the area of talking about reserves and having your eyes open before you go into a self-insured plan. Now, I'm bringing up some real problems there Mark, because as a whole, you don't have that happen. I would say probably you know, maybe 1 out of 20 have ever even know what a laser is, that are doing self-insured. But you just got to make sure that guys who set it up for you are professional and know what's going on with it.
So, that's why you wanna ask the questions, and know what's going on before you jump into something that later on you don't want to have a "gotcha." Yeah, and this I really appreciate that. That's one reason why we love working with you, and we recommend you to our clients. And one of the things practically that partial self-insuring or partial self-funding as we call it. It's really going to protect against some of that if they're concerned about those kinds of issues.
That way they're not gonna, that's not going to happen to them. Explain a little bit more, and we're a going to talk about reserves as well, in another hangout here. But explain to me, my be define for myself, our listeners, aggregate stop loss versus specific stop loss. Ok.
There's different terms floating around. Yeah, it's a, you know those are technical terms. But let's go back to our example. We were buying $100,000 of reinsurance.
So the reinsurance kicked in at $100,000. Let's say, and you remember I just talked about, if you have one large claim it's not too bad.
It's not going to hurt you. But what happens if you have ten. Let's say your group is 200 in size: 200 units.
And let's say you have 10 claims that come in that are over $500,000. Now, that'd be very unusual, but it could happen. And if it did, the way you're setup on self-insured, you'd have to pay the bill. So, you could have ten $100,00 payments you had to make, in addition to the premium you're paying
for the reinsurance, and the rest the of claims you're paying for the rest of the group.
So, you can run some very large numbers there. So the reinsurance company's to help you with that, knowing that if that happened it would be a very unusual thing. They will sell what's called aggregate. A lot of times in large groups, it's referred to as sleep insurance.
Just so that you're sure that you've locked in the most something could cost you. And so, aggregate insurance usally is done by your reinsurance carrier. It'll be under the same contract. They'll simply figure what you're expected claims are going to be.
They wanted 25 percent do that can come up with the spec or a number that your entire group as in aggregate as a total together did reach if the reach that number then they would go ahead and pay a 100
percent any bill from anybody from that point forward so let's
take our same example here two hundred thousand dollars back let's say we have
two hundred employees are units and in it it was a year expected claims are going
to be this billion dollars misuse use that as
a with 200 units that might be a little
bit low but no depends on where they rapin in the US
that our rates right now yeah we had that so
say here two million dollars is you're expecting claims they will set this back raid the that
aggregate raid at a hundred in are in it 1,000,000 and 250,000 so if you reach 1,250,000 in overall claims they will now go in P all clients even if you have someone that's never
met any of their deductible even the first five dollar they meet the
reinsurance cure basically will kick in and pay the additional on all a bit it using the that spec is
usually reached at a hundred and are 125 percent 25 percent more than
expected claims now they charge for that and that'll be
part of the quote that they would give you the %ah
give you a quote for the 100000 spec and then they'll give you a
quote for aggregate you can buy it with or without aggregate in like I said we call it
sleep insurance because most the time it does not use that you're ever in a case where you
have a lot of clinton's a large number of claims the end you'll
be really glad you bot aggregate because it limits your losses in so you can actually go into your
books in is the only only way you can figure on the
self-insured ok what your total budget could be is if
you have an aggregate on you grew gives them $1 million to $50 you know that's the most you're gonna
pay in addition to your third party administrator new PB
you know we should just pay in on a on a monthly
basis but you take that speck number one
million to $50 you add it to your TBA. Cost unit to your PB 0 that's the most it can cost you for the
year under self-insured if you have angered who it can be a very
good idea the smaller the group the more I
recommend going to an aggregate in it's simply
because usually smaller groups don't have the research to put in place to are set something that's Dennis
traffic k so a smaller group let's say YUM would
say we have bomb a lot of our overseas clients I
mean what you say we have you covered he units that are going to cover at
least some circles your allow what kinda but random amount dollar amount would
you I mean Justin general I mean ballpark mean obviously
we don't know the ages those people we don't know the club's history but adjusted just in general ballpark um what specific a what specific number are
we looking at generally what aggregate number looking
at generally is deductible let senator star Spencer
50000 100000 per individual per specific im when I do when you do a lot of a lot
brokers don't do this in I think they should andrew is coming into with the
pre-determined number so if they have a hundred or more than
90 say okay a hundred thousand is fine if they have two hundred or more than
they'll say in 150 to 200 is fine they may have a pre disposed number in mind on there's some brokers I would
tell you if you have 50 units you shouldn't be self-insured I is simply say you checked the market in you see once they hear so to tell you
what spec is right for you want that amount is I have to get the
numbers have to see what they are because your
group maybe younger in baby I'll very healthy et cetera there's a lot of
things that go into what the reinsurer what makes up the reinsurance quote then we basically put that into a
spreadsheet once we get those reinsurance numbers in we see what would happen for instance
I have several people that will tell me on a group of the you should go over sixty thousand
dollars in spec I would disagree and had a group B room just use me you little bit of allergies home trying
to know that I'm sorry but I have a group with eighty it for
several years have been on a spectrum a hundred and fifty thousand dollars but it's worked for that group in every
time the quote has come for the reinsurance
company we put it into a spreadsheet to look and how many claims they would have to
have how many those actually they have to meet igor
the premium paid was too much compared to a sixty thousand understand
a sixty thousand dollars but it's gonna cost you a lot more then a hundred and fifty thousand
dollars back just as a one thousand dollar deductible
plan cost you more than a five thousand dollar not play it's the same scenario you're just in larger numbers so I always look at what the quotas I'm I can see a case where 50 units could have a hundred thousand dollars
back it depends on the quote he and in that
case I would make sure they might aggregate in shirts with it when I would have that
in front of me so I be able to inform the client in an intelligent way so that they know
what it is so they know what their risk is and you know what's gonna happen in so I'm I am NOT one of those term I across the board there's just a
lot of folks out there that you're under 100 and size are gonna say
fifty to sixty thousand in Richards most the time I just tell you a little
secret there most the time brokers do look at commissions paid I know that's a
surprise for were some love you but they do in if they buy a lower spec 50,000 spec it's gonna cost you a lot more in you
see there's Commission bilby into that use each home when it's in the herd in
so if they're getting five percent let's
say I love that in Nome you know your premium is on 200,000 as opposed to a hundred
thousand they're gonna make twice as much as they
do on on that piece so that's why I put the numbers in from
the client in I do things that make it makes sense and you know I will put them at risk I
won't say where your group of 30 so must write two hundred thousand spec
who knows maybe it'll work this year maybe we'll
have a client no you don't do that in you should know in
self-insured there will be what they call the years 7 in after seven years you will have a bad
year it will happen in sometimes bad years
even come back to back because a lot and if you have someone
that has a large claim it may be ongoing in so sometimes those
aren't catch back to back the end so I don't 90 lay a certain
number and let the numbers tell me where to go
for that for that Klein wearing it yeah appreciate that that's really
the or the reasons why you know work with
you and have you up clients is so nice because I mean that
really is a sweet science industry background experience on the deck is it doing this for large
group for medium-sized its really is you know it's it's it's
refreshing and yeah I know it I notice I it's a
minute scene i've seen some other summer the ways you show that to clients
and and other breakdowns that not only in it
fully not going to self-insure does it was a little in cell culture but in up her please I'll find it but up partially self-insured that same thing
to help them really binder the sweet spot for them and there is the
slightest you have to be for the client mark I
mean that's it always takes care of itself but we really have a different gonna look at
it I mean I don't know what my company's new one
per se I don't look at it that way I don't go
you know if we would write this client then we would do XYZ. Idoney I look at the client's a you know
how can I help the client where that goes nope I may come to me and say hey let's
be self-insured I'm I'm looking at that lets go that route
in we may find out that the really can be partial self-insured but the really need to have what would
be normally known as fully insured product
in only have a two thousand dollar deductible in dude offer then it might make more
sense for them in by Silvestre someone that's very
young that has a lot of them you know very well people and they've
not had any claims and they feel like they're just foreign you know money into this big
insurance company and not realize anything it may make sense for
them no matter their size to go into a
self-insured product so again this be for the client units you know it's it's fine some christiana so we mentioned something
about these back to back claims her some no one in seven new starters on tape can
you top this little bit about I i know im stop-loss insurance
reinsurance there's you might hear these terms at 12
1215 12 $12.50 Nom just briefly he made the define the weather 15 well over 1250
would be in yeya somebody why that would be
important for somebody arm work itself insurance or so funding
most look a star let's start with the standard the
standard would be once referred to as a 12-12 contract means if
a claim was incurred in a 12-month period January through
December lets users an example they and the claim has to be incurred
from January 1 to December 31st and it also has to be paid from January 1 to December 31st that's a standard contract that will be
your lowest quoted contract in a lot of people will
say well that's not a problem I'll just do that well
here's the downsides a bit the a and number on the front we will only talk about
like the 15 12 yr 1515 understand and I well as go back to the
number how'd we get work well it just refers to the number of months
that is covered for the twelve on the front is for incurred
the twelve on the back is for paid oh now if I say 1512 that means we're going to cover 15 min
to be incurred whatever the dates are in that contract
in twelve months I love any so here's what happens so your brand new you're just going into
it your you're going to be 12 on the first
one is this going to be incurred in January to December you don't have to
worry about any time in the prior to January 1 because it's being handled by your
current company are whatever you're doing right now so we need run out claims and stuff that
may come from that are going to be taking care plan that
company so you're gonna have a 12 contract in your first contract if you
go who a self-insured typeof country then at the end up and that December 12 your cheapest reinsurance remember is
1212 so you're going to be tempted to in that at December 31st hoping because thats all you're doing hoping
that you will have a claim that incurs on let's say December 25th or 26th that's a catastrophically let's say a
heart attack as someone goes in form is in intensive
care and you have a period in there that you know you know it's not going to get
paid by time December 31st comes you know incurred there will be paid um now what's the chances of that
happening and that being very large it's pretty
small but I've seen it happen arm so what
happened with a group who had a 12-12 contract in a guy with Ian in December the 23rd any had the malfunctioning arm heart probably no. No heart monitor type: he and it got
infected they replaced it who they didn't get the infection
continued anyway without going into nuts-and-bolts they ended up with a two hundred thousand dollar claim in the
last part of that year their reinsurance was a hundred thousand
dollars though and they had two hundred thousand
it didn't kick in because the claim couldn't get paid by
December 31st remember the provider has to bill it has
to go through appo network up some Diet to get your
discounts the also verified that in fact it happen
me you know then to go through several things bien there's no way that is going to get
paid by December 31st so what happens is it doesn't meet the qualification at the
plan so it didn't pay ything in the school
had to pay that two hundred thousand dollars out-of-pocket because they were
self-insured um that can happen so how you how you
guardians that you may buy a 12 15 your first year in that's usually the one that i'm gonna
recommended that point this simply means it can be incurred in
the first 12 months but it can be paid over 15 minutes from
January 1 through March 31st so it should any claim even if stinker
December 31st should be able to be paid by December
31st expressions large plain gonna be aware then be there met I know
a lot of people that take the risk there you say when I am gonna pay that lower
now let me tell you sometimes you can find
the reinsurance company that will help you because what your intent with mine at
12:12 it's saving money right we all want to save money though
sometimes you can buy what's called an aggregating spec rape don't confuse that with everything else
ok talked about at this point B.
But it's where they may take those they
may take it and they'll say you pay three fourths over the premium for a hundred thousand dollars back he and if nothing happens then fine thats all UK. Then if you have a client then you will oh the premium with the rest of that 25
percent immediately in then we'll kick in at the
hundred thousand dollars so they give their premium if a claim
occurs after claim doesn't incur you get to keep it it's kind of a way
for them to share now that's not as you'll see it is often
today is she did at 1. Now once probably in 2002-2003 I was
very common you can find a lot of that I'm there are
companies still today that would do that you have to look for it but that could be mmm a way to offset mom that problem on the contracts now let's go the next step you bring new December 31st your your next january 1
so now this is your sexyy Ruiz now you want to make sure that there's
not a claim out there that has it been reported yet or you
don't know about so if you buy on your second year
08/12/12 that means if it's incurred January 1 going forward then it's covered well what if a claim incurred on
december twenty-fifth now your first contract you body 1250 well that's fine it went ahead and paid
for it if it went over the spec but if your renewal if you buy a 12
contract on the front Ian well if team let's say he just repeat
new by 12:15 again well any large claim that occur December
24th December 50 whatever that didn't have time to get
through the system is not covered so if those claims hit
you in January is not going to work any spec unless you
buy 15 50 now you're going to cover 15 months so
you can actually go back and you're going to cover anything from October November December that's
incurred and then for the entire year so January to December so that your fifty
Ian paid is 15 so it's going to be January 1
through March 31st to you so you may you should
buy your sexyy year probably at least if 1550 again I know folks that take the risk they
truly are self-insured when you take the rest there because there are suing and nothing's gonna
happen to them timing wise that would create a real problem iniki
so I'm always if you can do self-insured dude in such a manner that you can lock
in your risk I'm otherwise you're gambling you really
are gambling with dollars that in if you
don't have a very large reserve even if you do why do you want to risk
money when you can lock Indian know what your
risk years in be sure that it's there so those contracts to 1212 just make
sure you cover when is incurred in which made yeah and and Eli know specifically
there's this issue where special your national clients the OS. You get so many people coming home in so
many people's traveling for the holidays from from Thanksgiving onto the end of
the year and actually traveling back home were country they're leaving a recording
only expel home obviously right %uh but you know of their relief
worker there a you know their missionary you're there
I'm somebody teaching you know some school in Africa
someplace um lot at times get people traveling
over the holidays and so imagine you're saying is is very
relevant especially agencies that may not yet have really
train their people and a plan designed as a bit we've talked about before something you specialize in especially
if there are people who are coming home for treatment for things yeah and I they have a train them very
well so they're saving up all their medical issues till they come home for
the holidays and they want to know this treatment before they go back or is it and as really be a problem for a to z:
in just be aware we don't know how the rules are going to
come down but it is interesting if if the CIA makes it so that a returning missionary has 35 days in the
US and then they have to be on it 88 I play under whatever if if the or must back up Lesedi they come through as a rule that
says six months overseas is considered an expat in your exam from acha right without what you may see is a lot of folks that come home in
August were September in go back he and June or maybe because it carries over two years and
yet they can come close to the year be in there but they can still be six
months overseas so they're exempt in in that case if you have a lot of people coming home
toward the end of the year yeah you better make sure that you have
your coverage ride that them in in with missions guys also I just wanna not times a claim may be incurred wherever there
at in nobody knows about it for a while in it may take awhile for that claim to
come true it's not unusual for missionaries to turn inclined months
after the fact now you see those are smaller we're not talking major snow use if
there's a major dollar overseas I mean it's gonna be be even happier evacuation within its
era so hopefully you'll know your large
claims they're meant yeah you bring up some really good
points there just make sure that nom 3 if they see a forces everybody to you know can't come
home nom and certain period time in the house
be the into the year you you better make sure the year
contract ends in 15 at least on you may want to even up then
a little bit more I'm just two coverage but again premium pre-moderate we can put that all
together and we check it out in we see what makes sense in then you at least New Year s cool
into it so so I I liked it we do we touched a
little bit on laser an inherently sorry um agree that though any other things
you specifically can think up in terms of we've been talking now about
reassurances stop-loss but does specifically in terms of
international clients only one thing which was obviously I just brought up the fact international buyers
coming home lifetimes the holidays are traveling over how is that we talk about the fact that there that a lot of times
claims not to know about claims to later any other specific things about the
evacuation there were issues that you're national clients especially need to look at or smaller groups are
doing international were well as with money yes laser or read a statement well as self-insured plans and they say
well we're leaving our own plane so we really don't have to worry about where the claims are incurred in plan design
there's is huge in who if your self insured with
a hundred fifty thousand dollars back plan is just plain design is just as
important for you there as if your mind the five hundred dollar
deductible from you know I MGR at nursing it doesn't really matter you need to look at the
International has a large ppl so that it normally have claims are
incurred overseas they're cheaper than they were in the US.
The USO them Burgess highest place to get medical care people from all over
the world come here for care they do bennett not paying for in the same thing
with your plea in so really if your gonna send up
self-insured make sure you talk to someone in we
specialize in an I'm just making sure your plan design is
such that you're going to get the lowest cost for your claim Dollar that speed we have
group in art fifty to sixty percent other claims
are overseas in its amazing when they are there are a
lot of times their way below what their premium use their p in so if that's true with fully insured you can see what he would do all sorts
of insurance a plan design huge deal most people don't talk about okay so once again just summing up that
the international firm my they might be able to go with different amounts specific up area where simply because they're
dealing with overseas and or in their plan designed again set up in such a way where com maybe there's people treated differently if their
overseas as far as let's pay purses but stated that they come back to
you estimate that rumor if a if an international sending you would do the right plan design then I'd
be very comfortable with raising the specter great um because a lot of times those two
corley because if you get more claims over sees
you're gonna pay less warm and then if you have a larger energy you your claims just aren't very much um
with the rest of the group so you really wanna handle higher spec
on this in in Payless premium for the reinsurance
so now they are they they go together it's the know some
people do one will do the other meant it it well just not no is not one or the other so
yeah if you do self-insure them machine international city no
relation probably has a leg up on a normal company in the US. As the key and yet a beeper Diskin my
hand the claims overseas yeah at the same time though they may be
taking 10 bias and doing what study on the internet that's talking about so
funding it's a time it's basically the same so
coming from the basis other US company with claims in the US not
necessarily people overseas resources site as we talked about what
their party administration how important it is to get international no expert international dv8 aim same
quarter are trying to reach is or is a Showtime
are that that will have a GPA in the US. That they don't even know how to convert
many his between companies because what mister T
PA. Know it's a just a TV in their private
very good de Baux wet because there may be friends with
the organization or whatever their use in somebody to do their GPA
work that basically encourages everybody come home because that's where they're PBR network
is and that's where their claims are they understand in it becomes a hassle do international
claims coming from overseas so it's almost discouraged within the group well now you're almost assure yourself
that you're never 100 percent your claims in the US.
You know the nationalization I'll on the
money the years ago socialite more to say yeah those that that's a huge and
hopefully we'll address that on the website as well and talk about that
that's that's critical they don't this all that we talked a bit
about Lisa M and how when so many years later for a particular member of their group
or maybe your family in the area but
there's a at issue is running their family how they get laser diode or they're
being held hostage basically at that point if I could use this terminology by
the reinsurer because they kept their
insurance that point and now it's three times the amount that %uh percent
I'm be armed talking to yourselves any
recommendations on her insurer that it doesn't have a
history going out or made clear to him that well give us a couple ideas how can companies
or delays or as a template design is it in artists out all in the secrets of the
working with you are there some things you can say that we just hope our people under yeah I it's a secret sauce I'm its barbecue Redskins the city you
know I'm not really while the ladies ring really doesn't have
anything to do with plain design per se arm in really the only way to avoid it is out front planning is the plane ride in have the right company um some international companies will
guarantee renewal okay in they'll say we don't laser so that's a good way to go however now when they say that they will rescue so if you if you had a lot of large
claims they may not laser you no but your reinsurance me double from one year to the next you know it's it's better to find a reinsurance
company few key in that simply says we won't laser your
group in they'll put that in writing in his
party the plan document that that your best way there is really everything else is gonna I'm secondary
to it or like most people do is they just take
the risk and I'm I'm amazed how many people don't
even know till Asian can occur with them until it happens and yet let me just
give you example how that works with you we had a group ET units that we
were talking to you I mention lasering justina you know in
the visit well it is up at the end he told me
about a laser that he had to deal with you know the lady in
the office who was covered underneath their international plan I was pregnant he and just to the
renewal time near the renewal month: over their plan she had a preemie well that was a bad time because the reinsurance company came back input
on laser on the baby 972 thousand dollars because they knew it was a 28-month baby
or whatever they knew is going to be in their long-time in you don't intend seek ear neo-natal
unit in the US I mean your fifteen to twenty-five thousand per
day the you can run in those periods now you
may get some discounts from that meant is still gonna add up very rapidly in
that particular case what happened was the husband didn't
work for the unit in so they changed the baby in the
first 30 days over to his insurance so that employer got hit with it instead
the sending organization mine isnt organization what will you
done if you got the 972 what we've done they did not know they didn't have the
money they didn't have the reserves no one has those kinda reserves
necessarily to get hit by that so I just backed up
to at the beginning you have to send an
upper right in the only way to really really clarify on on Lee's remains just doe I'm my reinsurance from a company whose
going to laser you are who has it in a plan that the Kia in most of them do so may limit your companies you you kept from miss bill it's definitely worth it if it
happens no well worth is in the city it happens to you can't go anywhere you
can't do anything I can said previously i mean what are you gonna do with a 972
thousand-dollar laser you can't go to another reinsurance
company in and going to take you you can't go fully insured because
they're not gonna pick up that preemie so they're going to refuse you so your
stomach in so if they had my head the husband
working somewhere else they went ahead a penny 972 thousand
dollars plus all their normal operating costs
and all the other expenses on you most that could break a company ok spongier eighty so kinda brings me
back to that conversation we talk about on size you have to be aware that the smaller
the group the more you must make sure you don't
get lazy you know and I'll learn what's up that's daunting hearing that story
knowing this the care that we have here that you all have two words you know these groups especially you
know they're working or see is what I. Was doing great basin things on shoestring budgets
and am it almost makes me diste just want to tell everybody is the
partially so concerned about his book interests but Chris Carey but to is just lastly is have you noticed there's
any more common or less common not least ring in relation to
international them US. Laser in yeah no ranchers I'll majoring in mainly because most reinsurance carriers are
international carriers a 12 lund I mean that speaks for itself no White Mountains reinsurance is owned
by a serious international I'm Sweden um a lot every insurance companies are
very large there obviously their billion-dollar companies
I'm you know that cover risk and across the
board and Amy cover a lot more things in health risk
okay I'm using do there will be no backup P&C
carriers proper in Calgary carriers go back lots of things like that so I'm no I don't see really much difference it's just if your group is in the US. Nom in in most year people are getting
claims in the US.
Your ability to get to the high numbers is greater then if most your group is
overseas so that that's the only thing I would
say the air on on that laser impeachment know their
laser just based on you know we just based on their contract if they can
get you to agree to it you taking the risk they're not so it
did keeps their dude sorry he keeps their I'm renewal times happy
for them they are not cute costly as I said last
year but here's the here's a largely and I then all will do another 10 is on
now reserves and I think I'll important for
people to catch as well but I'm kinda like got credit now when you have a when you when you're
borrowing money and get bad credit very good thing requires
something how long will usually something take up say he's somebody had an issue cancer but its its over they've got a
clean bill of health they had free me um hit a huge bill but the you know obviously the babies
are born healthy in another how long does there's a through for
reinsurance the can't go anywhere else that next
year because obviously they have this huge crime how long we are sure people going to ask
how long to take for a company to get back in good standing with a cam n shop
around the inner armour back to be clean again it depends on the
key answer that you that it was in most cases cancer that is
cancer if you're cancer-free for more than five
years that's a typical rule of thumb and if you're more than five years they
won't count against you but I'm trying these days is a few actually have a letter from your doctor that requires you to be cancer
free then they use the don't hit you as hard they will take a chance on you at that
point so they may not but against the entire group as far as a
premium it's the same day I'm there are different preemie sorry
you can have ones I have ongoing issues and this members us up templates in des moines
iowa there were seven other me now we're born route I love those kids
were fine in the year to dampen they were in the
hospital for I believe it is almost a year before
they came out but then from that point on those fire in C. There's 20 2010 ongoing medical
treatment so it really depends on on what happens so a preemie can be just as adverse to you as as eighty
answer keys on so again in stitches piece by piece in in the hearings yes go back to know
the more information you can get on it in get to your to your insurance carrier or to your carrier is is the same rule the more information you can get there
on that you know some people will tell me well I don't want to ask any questions
about that stuff hate you can ask questions on your employees if if you learn some through the health
plan you can share with somebody else you can certainly find out as much
information as you can on something that goes on within your
employee base nom just for the fact that being able to
get your costs down so find out if somebody is going to be
treated any more not find out if they have that letter
that since Aon cancer-free I'm it will help you a lot on renewal in your age group here may not give you
a 75 percent increase in in or may get rid of a laser if you can
prove that in fact the rich then the girder ours not going
to happen so great question yeah so so does not
necessarily a year or two it its usually a bit longer than that going
to be banned yeah totally depends on them you may
have a cancer cases you know it's been ongoing for three
years and now they're cancer-free a reinsurance chair looks and it has
been won the group for a long time for something you've been quoted with them in for three years may have it wanna do
well in Union a cancer-free letter from the
doctor know certain they're like K listener the
game in is so they give you quoted will help you either your current carrier to stay down or come down or you may want to move
Richards here you can go in go with a new it was on whether the laser you're not 7
you well wonderful thank you so much deal
for just a wealth advice and information I think I hope this is helpful to our clients
I'll do we have a number of these are questions sorry there are looking at self-funding already have been self
funding for a while and considering somebody's various issues
whether it be the if they don't photo policy interests that or I'm where they're looking to you are
finally reassures carrier or there is issue so thank you so much I I
hope this is helpful and obviously I know you're available up
they can reach you through a good neighbor people have clients Decatur illicit boat GHR stock ombre obviously just go to the website if they're not are there already
I'm so-called publishers Takayama the graph paper there as well white
paper on I'm stop loss reinsurance they might also
help but to the I thank you very much and I will 40
questions long as as we can thanks sir thank you he said but I..
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