Provider Excess Loss/HMO Reinsurance, does it require a specialist?
Provider Excess Stop-Loss and HMO Reinsurance and Excess Provider Loss 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 carriers work with and give more consideration to premium to brokers who have history and experience in this product line.
Carriers refer us to other brokers who do not have the knowledge for this type of insurance. Large brokerage firms work with us due to the specialized nature of this coverage. Companies that purchase their coverage through other brokers specifically carve out capitation stop-loss/provider excess loss from their insurance profile due to the complexity of this coverage.
Also this coverage is not typical of other insurance products. It requires administrative actions throughout the contract year, i.e. monthly claims reporting, claim submissions, etc. McPhee & Associates have staff specifically dedicated to the required administrative actions.
Therefore the answer to the question is yes! You need an expert for HMO Reinsurance and Provider Excess Loss coverage.
Executive Vice President
McPhee & Associates, Inc.