HMO Reinsurance

HMOs desiring to reduce or control their risk of catastrophic claims need reinsurance. IndependenceCare Underwriting Services develops a thorough understanding of each HMO's risk exposure by asking questions -- lots of questions -- and analyzing information supplied by the client. We offer competitive pricing and innovative contracting because we understand each client's unique needs. We provide financial protection of the HMO's bottom line along with predictable year-to-year contract pricing and coverage, allowing HMOs to forecast and properly budget for reinsurance and medical loss expenses.

• Completed HMO reinsurance questionnaire
• Hospital and provider contracted rates
• A copy of the expiring contract
• Copies of the member service agreements
• Risk matrices detailing any capitated services not covered under the reinsurance contract
• Three years of claim experience based on the requested contract terms (current plus 2 prior years)
• Three years of membership reports, on a month by month basis, broken down by line of business
• Audited financial statements for three years plus updated quarterly NAIC statements

• Continuation of benefits coverage (also referred to as insolvency coverage)
• Conversion coverage

• $50,000 minimum deductible for eligible hospital services per member
• $25,000 minimum deductible for eligible professional services per member
• $50,000 minimum annual premium

IndependenceCare Underwriting Services also offers unique additional resources and products that may help significantly reduce the net reinsurance cost to our HMO clients.