Brokers, to get the best quote possible for your client, please provide the following Information:
The Standard Industry Code (SIC)/nature of industry.
The number of years in the business.
The address of the client’s headquarters and for client-prospects with other locations or subsidiaries, the city, state, zip code and the number of employees at each location. If the nature of industry is different by subsidiary, then please provide details.
Data to include for each participant includes the following:
- Date of Birth
- Dependent Status by Each Line of Coverage
- Plan(s) Participant is Enrolled in
- Zip Code
Enrollment counts by month for last 36 months - needed for an underwriter to develop the quote for aggregate Stop Loss insurance (best if single and family data is provided).
Other Plans - if the client provides other medical plans that are not being marketed (i.e., HMO) - provide the number of programs offered, and the corresponding enrollment for each program.
Paid Claims information by month for the last 36 months - needed to develop aggregate coverage.
Large and ongoing claim information - large claims at or exceeding 50% of the specific stop loss deductible for the last 36 months (diagnosis, prognosis, claim paid amount by year, the date of the onset of the condition, the treatment plan and/or /Large Case Management notes). Include claim information on any conditions that may not have reached 50% of the specific stop loss deductible during the policy year, but are considered to be ongoing conditions (examples include cancer, asthma, and AIDS) that are of serious nature and are required to be disclosed.
Identify the names of carriers for the past 5 years and provide the prior, current, and renewal rates and factors, as well as the details of the current coverage. If the current policy is self- funded., provide the Specific stop loss deductible amount, the contract basis, and identify the types of coverage that are included in the Specific stop loss policy, and in the Aggregate stop loss policy, as well as any notable contract provisions.
Provide a copy of the current plan of benefits, such as a Plan Document, an employee benefit handbook, or a current schedule of benefits. List details of any benefit changes that may be desired.