Fully Insured Alternatives
Other Minimum Requirements
- Twenty-Five (25) employees.
- Minimum Specific Deductible:$15,000
- Minimum Family Participation: NONE
- Minimum Monthly Premium: Cases with less than forty (40) Lives
- Any multiple employer groups & PEO's.
- Quoted as an exception if cases look clean with good history: mining companies, non-profit businesses, and unions.
- For groups with less than 150 employees and no experience, we can offer Specific and Aggregate quotes assuming all eligible employees complete individual health statements. On the basis of the health statements, we may require additional medical information, place lasers, or adjust the initial aggregate factors quoted.
- Available for all groups: 15/12, 12/12 and 12/15.
- Also available for groups renewing with the incumbent TPA: 24/12, 18/12 and 12/18.
- An employer must sign a statement regarding extra liability when accepting a 12/12 contract basis on an existing group.
Excess Loss Reinsurance Features
- RX Card
- RX card coverage is available upon request at time of quote under the Specific.
- RX card coverage is available upon request under the Aggregate when Aggregate RX experience is provided.
- Aggregating Specific is available depending on case and circumstances.
- Specific Advance is available when requested.
- Aggregate Accommodation is available for smaller groups. Rate is $1.50 per employee per month and is non-commissionable.
- Offer 2-tier, 3-tier, or 4-tier rates, but prefer to use 2-tier rates; single & family.
- Depending on circumstances, we can offer different rates for plans or locations.
- Policy Years
- We do not write a treaty for a period longer than 12 months.
- On an exception and depending on circumstances, we can quote contract less than 12 months.
- Medical Conversion is not available.
- Maximum TPA Commissions: 15%
- Maximum Percentage of Retirees: 15%. For groups with a greater percentage, an exception would be required.
- Groups OTHER than single employers may not be quoted.
- Policy Limitations: Review the insurance company policy form for any limitations. (Available on request.)
Submission of Application and other Case Requirements
- Premium, application and disclosure can be submitted within 20 business days of the effective date.
- Coverage is not bound until all of the underwriting requirements have been received, approved by our office, and in case of rate changes or lasers accepted in writing by the employer.
- Specific rates can be finalized based on 11 months of claims data; however, on-going claims situations are subject to laser.
- If the TPA is incumbent on the case, aggregate rates can be finalized based on an 11 month current year aggregate report.
- If the TPA is not the incumbent on the case, aggregate rates can be finalized based on a 12 month current year aggregate report.
- We make our best effort not to change quoted rates and factors.
IIS partners with proven cost control vendors to provide additional products and support services to our payor partners and clients. As these unique situations arise, we would be happy to recommend an appropriate vendor to assist in all types and aspects of claims.
*Note: We will quote only for TPA's who meet approval requirements. If you would like to be considered, please download a TPA Application and Questionnaire
and submit them to us.
Information required by IIS to quote a group
- A current Census (including employer address and the following employees information: date of birth, zip code, gender, and dependent status).
- A current Plan of Benefits.
- Most recent 2-3 years of claims experience with aggregate reports or premiums versus claims for fully insured groups, if available.
- 50% Notifications and any Potential Large Claim Disclosures.
- Employer's Industry and Location(s).
- Current and Requested Contract Basis and Specific Deductible.
- Any PPO Network(s), precert company, UR company, LCM company, or RX vendor used for a given quote.
- Commission requested
- Current carrier and rates (Please provide any commission included in current rates)
Excess Loss premium payments are due to IIS within 30 days from the first of the month for which coverage is applicable. If payments are not received within 30 days, the group is subject to termination without further notice. Any notifications or warnings produced are completed as a courtesy and not required by the excess loss treaty.
Regular or Overnight Delivery
International Insurance Services (IIS)
10 South LaSalle Street
Chicago, IL 60603
Premium payments should be made payable to the carrier of coverage. Payments must be submitted with a Premium Remittance Statement Worksheet
. TPA produced worksheets are acceptable provided the following information is disclosed:
- Month of Coverage
- Group Name
- Treaty Number
- Effective Date
- Coverage Rates
- Enrollment Counts by Tier
- Calculation of Premium
- Person to Contact with Questions
For more information, contact the Accounting Department at (800) 786-0500.