Underwriting - Medical Stop Loss
Underwriting
medical stop loss is the core business function of HCC Life Insurance Company. In conjunction with superior underwriting services, HCC Life Insurance Company provides related value-added services such as catastrophic claim valuation and actuarial review, including plan changes and provider network, evaluation and stop loss pricing impact.
The products we offer are competitively rated, offering aggregate and/or
specific stop loss insurance to employers with a minimum of fifty employees. Our goals are to offer tailor-made benefit packages, equitable rates and prompt and thorough service to both plan sponsors and Third Party Administrators. We have both the experienced support staff and creative, knowledgeable underwriters to accomplish these goals.
HCC Life Insurance Company's Third Party Administrator Guide is offered to assist our producers and Third Party Administrators with answers to most underwriting questions. The Guide contains information regarding:
- Product offerings
- Desirable and Undesirable group characteristics
- Required info to prepare a proposal
- Post - Sale procedures
- Producer Agreement
- Other State-Specific Requirements
Our Quote Submission Checklist indicates what is required for us to provide an accurate and competitive quote.
NetValue
HCC Life Insurance Company understands the dynamics within the changing managed care environment. NetValue is just one of the many value added services we offer our clients. Through NetValue, HCC Life Insurance Company continues to maintain its competitive edge in providing
stop loss insurance for the self-funded marketplace.
How is NetValue used?
NetValue is a proprietary HCC Life Insurance Company program that evaluates the strength of health care provider networks. It stands apart in the marketplace as a value added support service for underwriting HCC Life Insurance Company's
medical stop loss business. While its primary impact is on medical stop loss pricing, NetValue equips the broker and TPA with innovative marketing tools.
To get started, the provider network completes HCC Life Insurance Company's Managed Care Network Questionnaire. Cost, access and outcome data are analyzed by HCC Life Insurance Company's actuaries.
Maintaining a competitive edge
HCC Life Insurance Company is always looking for superior network value in each of its markets. HCC Life Insurance Company is determined to participate with strong managed care organizations.
Network marketing
HCC Life Insurance Company is nationally recognized as a leader in underwriting
medical stop loss insurance. Evaluation and qualification of networks by HCC Life enhances a network's marketability to brokers and TPAs.
What is the charge for this service?
HCC Life Insurance Company's NetValue services are available as part of our stop loss program. There is no additional cost to prospective and renewing clients.
Who Benefits?
Employees know that the employer, administrator and
stop loss carrier have selected a network based on overall value. Selection takes into account access, quality and cost. NetValue also assists employers in selecting multiple networks for out of state locations.
Brokers and Third Party Administrators can access managed care networks that produce the best value in their market. With HCC Life Insurance Company's NetValue, they can take advantage of an independent, unbiased evaluation. The TPA may also choose to streamline administration by assuming re-pricing functions that a network chooses to outsource.
Managed Care Networks that deliver quantifiable value can take advantage of NetValue as a marketing tool. Networks that deliver superior value are recommended by
HCC Life Insurance Company to brokers, TPAs and employers.
HCC Life Insurance Company can produce competitive quotes on prospective managed care business by knowing that a given network has been comprehensively analyzed based on the proven effectiveness of providers and hospitals in reducing claim costs.
HCC Life Insurance Company has been evaluating managed care networks since 1994. Over 600 networks have been reviewed and updated under the NetValue program. The database includes local, regional, leased and national networks that range in delivery of care, discounts, size and service area.
Through our Managed Care Network Questionnaire and CPT4 Codes List,
HCC Life Insurance Company actuaries review each network for provider adequacy (type and count), access fees, hospital contracts, physician fee schedules, risk contracts and tertiary care arrangements. NetValue accesses credentialing procedures, medical management resources, practice patterns and outcomes. The data is matched against national benchmarks including Milliman USA's Health Cost Guidelines, Medicare RBRVS and Solucient data.
Measuring Effectiveness
The results of NetValue's analysis are continually reviewed against HCC Life Insurance Company's paid claims database for accuracy. If warranted, modifications are made to pricing models. NetValue is an ongoing review program that rewards superior network value with the best discounts on
stop loss premium.
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Appointment Process
