by Elizabeth Midtlien, Second Vice President,
Employer Stop Loss Distribution

Healthcare Risk Management

Allianz Life Insurance Company of North America

It sits on your desk staring at you. It might even have fallen victim to the “procrastination pile”. You have been sold on the need for employer stop loss coverage, but making the decision on which carrier to use is another story. All of the information from the carriers is starting to look the same. Where do you begin?

The decision might not be easy to make, but with the proper information, you can come to an educated choice. Here are eight key factors to consider when you make your choice on which employer stop loss carrier to give your business:

·        Reputation. Your employer stop loss carrier must have a solid reputation with both the brokerage and administrator communities. How much business have they placed with the carrier? Does the employer stop loss carrier actually deliver on the promises that they make? Get on the phone and ask your favorite broker/administrator what they think about a certain carrier. Chances are you will get the full truth, good or bad.

·        Johnny-come-lately. How long has the carrier been in the employer stop loss industry? The best carriers can demonstrate sustainability. After all, you want to make sure that the carrier will be there to serve your needs in the near and long term future. Fair pricing is often a good indicator of sustainability. A fair price that is good for the customers and profitable for the carriers is a positive sign that your carrier means business and better yet, means to stay in it.

·        Dedication. How important is the employer stop loss insurance portion of the carrier’s overall business? Is employer stop loss just one item on a 10-page menu of every type of financial and insurance product available? Determine if they have a dedicated, high level of expertise.

·        Gatekeepers. Who is making the underwriting decisions? Who is it that is making the final decision on whether or not your claim is going to be paid? Make sure the right people are making the right decisions. It’s your money. You don’t take their decisions lightly and neither should they.

·        Risk. A carrier that is willing to take risk is a carrier that needs to be on your “short list” when it comes down to making the final decision. Find out how much risk the carrier retains and who is really taking the risk.

·        Customer service. Make a point of evaluating the carrier’s customer service. It can speak volumes about the overall character of the company. How fast are claims reimbursed? How quick are contracts issued and renewals offered? Don’t sacrifice anything in this department. The overall level of service should be high and it should be all about service, service, and even better service.

·        Special benefits. Many carriers offer special benefits to try to get your business. Make sure that they are worthwhile for your organization and that they are high quality. Are the special networks certified by nationally recognized organizations for their quality and processes? Do your homework when it comes to researching transplant and specialty networks and find out if they have the right credentials as well as good medical outcome rates.  For example, you may want to consider organizations that offer its employer stop loss clients accredited transplant networks. While no one can predict that one of your employees might need a transplant (and hopefully they won’t), this service can provide assurance to clients that they are getting access to some of the best transplant centers in the country, while being part of one cohesive service as compared to working with several different companies. This can help to control the unpredictable high costs of procedures along with providing the benefit of the network discount. Although this might not be the best benefit for your organization, it is representative of some of the specialty benefits that you need to look at when making your choice.

And last, but not least, the eighth and final factor to consider when making your decision on which employer stop loss carrier to go with:

·        References. Yes, it’s just like a job interview. Ask the carrier for employers, brokers, administrators, consultants and anyone else who does business with them. Find out about their experiences with the carrier as well as get the details on any outcomes they might be willing to share with you. Talking with a third party can sometimes help clear up a cloudy decision making process and can set one carrier apart from another.

No one said it was going to be easy. But taking these eight factors into consideration can help you make the right choice on which employer stop loss carrier is the best fit for your organization.

For more information please contact Elizabeth Midtlien at 1-800-328-5600 or via e-mail at elizabeth_midtlien@allianzlife.com  or visit our website at www.allianzlife.com/divisions/reinsurance.asp