Does Provider Excess Loss coverage require an expert?

Oct 31, 2013

We believe that there can be cost savings and ease of administration for the E&O/D&O/Umbrella/Property, and other insurance products under one broker.  However, capitation stop-loss/ACO coverage is not one of these products. Capitation stop-loss/Provider Excess and ACO coverage is a specialized insurance product offered by only a select number of insurance carriers.  These carriers or division of carriers do not intermingle with the other types of coverage sought by health care providers.  In fact these carriers work with and give better consideration in reference to premium and coverage to brokers who have a long history and experience in this product line.

Due to McPhee’s expertise, carriers have referred us to other brokers who had approached them but did not have the knowledge for this type of business.  Large brokerage firms have approached and work with McPhee due to this specialized arena.  Large companies that purchase their other coverage through other brokers specifically carve out capitation stop-loss from their insurance profile with the other brokers due to the complexity and expertise needed for this coverage.

This type of coverage is not typical of other insurance products as it requires constant administrative actions throughout the contract year, i.e. monthly claims reporting, claim submissions, etc. McPhee has staff specifically dedicated to this, unlike other larger firms.

Carriers will attest to our expertise, experience, client representation and high ethical standing for 30 years in the capitation stop-loss industry.

Since we also provide reinsurance to HMOs we are in a unique position to know the needs and wants of the managed care industry.  We not only market stop-loss coverage for our clients, but also have written the language for stop-loss policies for carriers.

Contact us, we can assist you in providing the optimum coverage for the best price.

Susan Kattoo
Executive Vice President
McPhee & Associates, Inc.
(818) 541-7900