Want to quote with Auxiant on a Self Funded Group?

New Business RFP Checklist

Certain elements are required to get any sort of proposal from stop loss carriers, such as census, and aggregate claims. You may find that we ask for a good deal of information as we analyze your plan and shop your stop loss insurance; we do this for two reasons:

  1. We need to have a thorough understanding of your current program so we don't miss anything - we want to propose a proper program going forward;
  2. We find stop loss underwriters hedge less conservatively with more information. i.e., we can get better deals for you. Below is a checklist to assist the employer in assembling information needed for a health plan proposal:
  • Corporate Name, address, nature of business and SIC (if available).
  • Census Must include Name, Sex, Date of Birth, Home Zip Codes and coverage status (e.g.Single/Family), please provide census in excel format. COBRA participants and retirees must be identified. If a Group Life quote is desired, we need to know coverage amounts. If an LTD quote is desired, we need to know covered payroll for each individual.
  • Month by Month Claims Paid Report for the current year and each of the previous two years. This would list the month, the amount of claims paid for the group in that month, and the total number of covered employees for that month. (Typically an "aggregate report" will provide this)
  • Shock Claims Information for the current plan year and each of the preceding two years. This is a report that would list any individual who has had a serious diagnosis, and/or who has had claims paid over 50% of the specific deductible. Information needed includes: Name of the patient, amount paid for each year, the diagnosis, and the current condition/prognosis.
  • Plan Benefit Information A copy of the SPD - Summary Plan Description or coverage booklet for the benefits requested - i.e., medical, group life, group ltd, dental, etc.
  • A copy of the current rates, prior two years rate history and renewal rates.
  • A copy of the latest month's billing, so that we can see locations covered and don't miss any individuals.
  • A copy of the in-force stop loss contract or insurance agreement. This is important so that we obtain quotes for the proper contract type to follow the in-force policy.