Underwriting
With each over twenty years of experience, the NUS Underwriters are seasoned professionals that take pride in making sure that the underwriting process with NUS for our clients is personalized, efficient, and as flexible as possible. The NUS underwriting process is much more than a computer-generated rating-manual basis; we “think outside the manual,” looking for ways to say, “yes, here is a way to do this.”
General Underwriting Criteria for Medical Stop Loss:
· Minimum Case size: 50 lives
· Minimum specific: $25,000
· Contracts: standard contract periods are available.
· Actively-at-work- can be waived upon approval of disclosure form.
· Lasering: is utilized on new cases subject to detailed medical evaluation on claimant(s); however, on renewal cases, we try to avoid it entirely and present other options, unless absolutely necessary as a cost control measure.
· Experience: two to three years experience is required on currently self-funded cases; the current rates and factors, as well as the renewal, if available, should be furnished. Both aggregate and specific reports are required showing claims and enrollment for each period on a monthly basis, with shock claims information including status and prognosis.
· No Experience available: groups under 100 employees can be considered if current, prior, and renewal rate history is available and other normal criteria is met.
· Industry restrictions: no associations or employee-leasing firms, or highly hazardous (individual consideration for some exceptions).
· Preferred Provider Organizations: can be evaluated for discounting, if not already done.
· Utilization/Case Management: furnish current and proposed providers.
· Benefits: for each experience period and proposed should be furnished.
· Census: an age-banded census or full census in an excel format should be furnished.
· Optional Features:
Monthly Aggregate Accommodation
Aggregate Terminal Liability
Aggregated Specific
Specific Terminal Liability
· Noble Guardian Program: when incorporated into the Plan Document language, the comprehensive medical bill review services can be utilized to reduce fixed costs and/or limit laser liability for large ongoing claims. Historically on NUS claims audits, an average savings of 51% over billed charges is achieved.