OUR SERVICES
STOP LOSS MARKETING
Your team is busy and stop loss probably isn’t your core business. We provide access to more markets while simplifying the entire marketing process. Why not push the “easy” button and leverage our stop loss expertise and preferred carrier relationships for your next renewal?
Every company is different, even those in the same industry. That’s why we focus on creativity and flexibility when we build a stop loss solution. The entire process from “Let’s Talk” to bound coverage can be as quick as two weeks. Working with us usually looks something like this:
1. Plan
5. Present
2. Collect
6. Finalize
3. Evaluate
7. Monitor
4. Market
8. Repeat
1. Plan
First, we’ll connect with you on the phone or in person. We’ll work to establish your timeline, understand your client’s goals, and develop a custom strategy for the stop loss marketing.
2. Collect
XL Benefits then works with your team and, when available, the third party administrator to collect the data necessary to quote. In general, the more information we can review the better. At a minimum we gather the census, plan design(s), rate history, and whatever experience is available.
3. Evaluate
Our team performs a thorough review of the information received paying special attention to the plan design, claims experience, and plan/cost containment vendors. When evident we provide feedback and analysis on opportunities for potential savings.
4. Market
Our account management team then prepares the information in our carrier-friendly package, explaining each account’s unique story and outlining our marketing objectives. Over the course of the following week(s) we answer carrier questions, prepare proposals, and aggressively negotiate the stop loss terms.
5. Present
Once the initial marketing is completed we prepare the proposals, comparisons, specific deductible analysis, and claim summaries for your client meetings. These items are fully customizable and can be branded with your logo and preferences. We are also available to provide in-person sales support for your client meetings.
6. Finalize
Once direction has been given from the initial proposals we work with the TPA and carriers to finalize and firm their stop loss proposals and terms. We then prepare the firm quotes along with the disclosure paperwork, premium remittance forms and applications for binding. Once the coverage is bound we are available to provide illustrative fully insured equivalent and COBRA rates.
7. Monitor
After binding the coverage and policy issuance we work with your team to monitor the monthly claims experience and the ever changing healthcare compliance requirements. We provide claim analysis reporting and cost-containment recommendations as specific conditions arise throughout the year. In addition, as specific or aggregate claims are filed we work with the carrier and TPA to ensure accurate and timely claim processing and reimbursement.
8. Repeat
In accordance with your timeline and the client’s goals, XL Benefits works with the TPA and the stop loss carriers to provide competitive renewals year after year. We provide turn-key solutions that make the whole renewal process a “piece of cake.”
SELF-FUNDED CONSULTING
Because there’s more to self-funding that just stop loss marketing. XL Benefits is your self-funded consulting partner, ready to provide education, support and guidance in all things self-funded. Below are just a few of the additional services we provide.
Fully Insured
Analysis
Self-Funding
Education
PBM Evaluation
Claims Analysis/Oversight
SPD/Contract Evaluation
Cost Containment Advice
Fully Insured Analysis
With self-funding providing coverage to over 60% of America’s workers, for most groups it is a viable and competitive alternative to fully insured plans. By reviewing a group’s demographics, plan design(s) and claims information we help you determine whether your client is a good candidate for self-funding. If it is we help you explore the various self-funded options including bundled, unbundled, traditional stop loss, level-funding, and captive arrangements.
Self-Funding Education
With XL Benefits on your team you have an expert in self-funding. Not only do we provide you with the knowledge you need to understand the evolving self-funded options but we work with you to educate your clients. Through self-funding seminars, client presentations, and our web blog (Insights), we help you make sense of the complex world of self-funding - keeping you informed of the latest trends and best practices of the self-funded community.
PBM Evaluation
Prescription drug costs are an ever growing concern with most groups paying 12-20% of their overall health costs on prescription drugs. And with Rx trend outpacing the average medical trend finding the best PBM partners is more important than ever. XL Benefits has you covered! We can assist you as you evaluate PBMS and your formulary to ensure both great coverage for the members AND low costs for the employer.
Claims Analysis/Oversight
We work with your team to monitor the monthly claims experience and the ever changing healthcare compliance requirements. We provide claim analysis reporting and cost-containment recommendations as specific conditions arise throughout the year. In addition, as specific or aggregate claims are filed we work with the carrier and TPA to ensure accurate and timely claim processing and reimbursement.
SPD/Contract Evaluation
Unfortunately, not all stop loss policies are created equal and although stop loss can easily be treated as a commodity, it isn’t one. While price is important, saving a few thousand dollars isn’t worth it when claims are denied. We have already evaluated most stop loss contracts and only work with A rated carriers. In addition, we evaluate your client’s plan document against the stop loss policy to avoid coverage gaps due to exclusions, carrier definitions, or contractual differences.
Cost Containment Advice
There are literally hundreds of cost containment vendors serving the self-funded community today. While we don’t know all of them, we know many of them and will offer direction as issues arise. In addition, we do not partner with any of these vendors so we are not biased in our recommendations. Our goal is to provide guidance and turnkey solutions.
FINANCIAL FORECASTING
While we haven’t found a crystal ball that is able to predict future claims and costs, we do subscribe to actuarial principles that get us close. When you work with XL Benefits you have a partner who can provide claim projections, fully insured equivalent rates and COBRA calculations based on actuarial principles. To learn more, click on the icons below.
Plan Design
Analysis and Benchmarking
Rate Development
COBRA Calculations
Plan Design Analysis and Benchmarking
The ability to craft a customized plan design based on your client’s experience is one of the greatest benefits to self-funding. Unfortunately, there aren’t many tools available to help you determine the financial outcomes of those changes. When you partner with XL Benefits you gain a partner who can assist you with claim forecasting, predictive modeling, and cost projections based on proposed plan changes, vendor selection, PPO access and other cost containment solutions.
Rate Development
In self-funding it is rare for a group to have the normal rate structure that groups are used to. Stop loss is usually sold on either a two-tier or composite basis and many employers do not purchase aggregate coverage. As a result, most self-funded groups need help developing their fully insured equivalent rates based on actuarially sound principles. We provide this expertise freely to our clients and for a moderate fee for our “future clients.”
COBRA Calculations
While not every group requires fully insured rate equivalents, every group needs COBRA rates by plan. Using the same actuarially sound principles we illustrative COBRA rates that include several funding levels that can be customized for each group’s risk tolerance and reserve strategy. We provide this service freely to our clients and for a moderate fee for our “future clients.”