Self-Funded Breakdown

Report
Targeting 5 to
100 life groups
Starmark’s Self-Funded products provide administration and stop-loss
protection for small and mid-size businesses self-funded plans.
http://www.starmarkinc.com/email/starmark/T500-227.html
How Starmark’s Self-Funded Programs Work
http://www.starmarkinc.com/email/starmark/T500-227.html
Claims Pre-Fund Account
When employees have claims, the covered claims
are paid out of the claim pre-fund account.
If claims are more than what is funded, the stoploss insurance pays the balance.
If claims are less than what is funded, the surplus will be
returned either as an administrative fee credit or cash.
http://www.starmarkinc.com/email/starmark/T500-227.html
Surplus Options
•
•
Cash Refund
Administration
Fee Credits
Run-Out
•
•
•
http://www.starmarkinc.com/email/starmark/T500-227.html
12/21
12/24
12/27
Initial Quote
•
•
•
•
Group Name
Zip-Code
SIC-Code
Census
http://www.starmarkinc.com/email/starmark/T500-227.html
Benefit Summary
• HSA Qualified Plans
• HRA Administration
•
•
•
•
•
•
•
•
•
Networks
Deductibles
Co-Insurance
Out-of-pockets
Preventive Care
X-ray and Lab
High-Tech Imaging
Lab Card Program
Prescription Drug Card
•
•
YourCare
CareChampion 24/7
http://www.starmarkinc.com/email/starmark/T500-227.html
Contracts
Plan Document/Summary
Plan Description
Certificate of Coverage
http://www.starmarkinc.com/email/starmark/T500-227.html
ID Card
Submission Process – Full Medical Underwriting
• Employer Application
• Employee Applications
• Sold Proposal
• Prior Carrier Bill
Paper Applications,
or
Express Connect
• Online, or
• Telephone 800#
Final Offer
http://www.starmarkinc.com/email/starmark/T500-227.html
Pricing
Family Status
Number of
Employees
Cost
Employee
10
$328.28
Employee and Spouse
2
$755.08
Employee and Child
1
$529.71
Full Family
3
$956.51
Total Monthly
http://www.starmarkinc.com/email/starmark/T500-227.html
$8,192.20
Self-Funded Breakdown
Attachment Point
Specific Deductible
15,000
Annual Aggregate Attachment Point
35,354
Annual
Point –for
The
overall
claimperson
liabilitythat
of the
SpecificAggregate
DeductibleAttachment
– Eligible claims
each
covered
are
employer
the contract
All eligible
in excess
of this
more thanduring
this amount
duringperiod.
the contract
periodclaims
are paid
by the Stopamount
are paid by the Stop-Loss Insurance.
Loss Insurance.
Total Monthly Cost
Stop-loss Premium
$3,879.22
Administration Fees
$1,366.81
Claim Prefunding
$2,946.17
Total
$8,192.20
http://www.starmarkinc.com/email/starmark/T500-227.html
Contracts
Agreement for Plan
Supervisor
Stop Loss Contract
http://www.starmarkinc.com/email/starmark/T500-227.html
Aggregate Account Statement
Deposit
Claims Payments
Balance
Month 1
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Month 9
Month 10
Month 11
Month 12
Surplus
http://www.starmarkinc.com/email/starmark/T500-227.html
13
Claims Utilization Reports
•
•
•
•
•
Medical enrollment by Month
Summary by Patient Type
Summary by Service
Summary by Diagnostic
Category
Prescription Drug Report
http://www.starmarkinc.com/email/starmark/T500-227.html
14
Broker Commissions
• Commission percentage is based off the stop-
loss premium
• Can be adjusted up or down at new business
and renewal
http://www.starmarkinc.com/cps/rde/xchg/starmark/hs.xsl/MGA_LicensingCommissions.htm
Current Bonus Program
http://www.starmarkinc.com/2013bonusprogram/index.html
16
What’s Next?
• For Quotes & Personal Consultative Assistance,
Contact HealthPlan Services’ Licensed Sales
Team:
• 800-545-6441
Medical | Dental | Vision | Life | Ancillary
Group | Individual | Voluntary
www.healthplan.com

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