Targeting 5 to 100 life groups Starmark’s Self-Funded products provide administration and...

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


http://www.starmarkinc.com/


How Starmark’s Self-Funded Programs Work




Claims Pre-Fund AccountWhen employees have claims, the covered claims are paid out of the claim pre-fund account.

If claims are more than what is funded, the stop-loss 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.




Surplus Options

• Cash Refund• Administration

Fee Credits

Examples

Run-Out

• 12/21• 12/24• 12/27




Initial Quote

Census

• Group Name• Zip-Code• SIC-Code• Census




Benefit Summary

• Networks• Deductibles• Co-Insurance• Out-of-pockets• Preventive Care• X-ray and Lab• High-Tech Imaging• Lab Card Program• Prescription Drug Card

• HSA Qualified Plans• HRA Administration

• YourCare• CareChampion 24/7




Plan Document/Summary Plan Description

Certificate of Coverage

Contracts

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




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 $8,192.20




Annual Aggregate Attachment Point – The overall claim liability of the employer during the contract period. All eligible claims in excess of this amount are paid by the Stop-Loss Insurance.

Specific Deductible – Eligible claims for each covered person that are more than this amount during the contract period are paid by the Stop-Loss Insurance.

Self-Funded BreakdownAttachment Point

Specific Deductible 15,000

Annual Aggregate Attachment Point 35,354

Total Monthly Cost

Stop-loss Premium $3,879.22

Administration Fees $1,366.81

Claim Prefunding $2,946.17

Total $8,192.20




Agreement for Plan Supervisor

Stop Loss Contract

Contracts




Month 1Month 2Month 3Month 4Month 5Month 6Month 7Month 8Month 9Month 10Month 11Month 12

Deposit Claims Payments

Balance

Surplus

Aggregate Account Statement




13

Claims Utilization Reports

Reports• Medical enrollment by Month• Summary by Patient Type• Summary by Service• Summary by Diagnostic

Category• Prescription Drug Report




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



Targeting 5 to 100 life groups Starmark’s Self-Funded products provide administration and...

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