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  • Integrated Healthcare Consumer Driven Healthcare - An Integrated Solution Integrated Healthcare, LLC, the sister company of GreenWood International Insurance Services, Inc, delivers a revolutionary point-and-click Consumer Driven Healthcare Platform that merges both health and wealth information, giving employees easy access with just one log-in. This platform strives to change employee behavior through financial incentives and informational tools including Health Savings Accounts, smoke-cessation programs, weight management programs, and health risk assessments.

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Frequently Asked Questions about Medical Stop Loss

When working with a TPA or broker for the first time, questions are bound to arise. At GWI, we have the knowledge backed by experience to answer your questions and address your needs. Below are a listing of commonly asked questions, but if you find your question is not answered below, do not hesitate to speak with a member of our team. We are always just a phone call or e-mail away.

What is medical stop loss coverage?
Medical stop loss is an insurance product that provides protection against catastrophic or unpredictable losses. It is purchased by employers who have decided to self-fund their employee benefit health plans, but do not want to assume 100% of the liability for losses arising from their plans. Under a medical stop loss policy, the insurance company becomes liable for losses that exceed certain limits called deductibles.

What are your disclosure requirements?
We require a completed and signed disclosure form, aggregate claims through the effective date, a report showing anyone who has reached 50% of the specific limit in the current year including their diagnosis and prognosis, anyone who has $10,000 or more in pended claims, anyone who has been pre-certified for a 5 or more day hospital stay, anyone who has requested a transplant or who is on a transplant list, and anyone not expected to be at work on the effective date due to disability or a dependent who does not meet the “Actively at Life” definition.

What is required to submit an RFP?
See view our Underwriting Guidelines.

What is your turn-around time for new quotes?
We generally require 8 business days from the day we receive complete information to develop a quotation. If the information is not complete, we will pend the quote until we receive the missing data. The quote is then assigned to an underwriter and the 8 days cycle begins. From time to time we are able to quote with less than 8 days by special request.

What is the minimum group size for which your company will issue a proposal?
25 employee lives

What are your sold case procedures? How many days ahead of the effective date will you bind coverage?
After disclosure is completed and reviewed, the underwriter sends out a binder form. This binder informs the producer and client that underwriting has been completed (except for any contingencies noted on the binder – usually a request for the 12 month of current year's claims), and that coverage has been accepted. We will require this form to be counter signed by a designated office of the Policyholder. We can bind up to 30 days prior to the effective date. Approximately 2 weeks after the binder is issued, we send out a completed application and policy for review and signature, along with a claim administration kit.

Do you laser? If so, do you laser at renewal? Do you provide a no-laser option?
We do laser both on a new sale and at renewal. Our philosophy is that premium is for unknown risks; we laser in order to keep current and future premiums as low as possible. We will, however, provide a non-laser option upon request.