ADMINISTRATION

Policy Issue

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Premium Payment Procedures

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Commission Payment Procedures/Agent Appointments

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Reinstatement Procedures

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Monthly Aggregate Claims Reports

 

Policy Issue

 

After completion of the post-sale underwriting analysis and review and acceptance of the Plan Document, the stop-loss policy will be issued and forwarded to you.

 

 

Premium Payment Procedures

 

Premium is due on the first of the month.  A grace period of 31 days is allowed for the payment of renewal premium.  If we have not received the overdue premium within the grace period, an email will be sent to you notifying you that the account is delinquent.

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The following is an outline of the time-table applicable to premium remittance.

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• Premium Due Date (1st Day of the Month) ​New Accounts - Binder must be paid by the initial effective date

• Grace Period Ends (31 Days)

• Notice of Delinquent Account (31 Days)

• Cancellation Notice Sent to the TPA (45th Day)

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In the event a case is canceled, a reinstatement application and instructions for the cancellation letter that was sent to the insured.  Please see “Reinstatement Procedures” for further details.

Premium submissions can be submitted with our premium worksheet or some format that includes the following information:  (Group Name, Month Paid, Counts, Volume)

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Please note the following regarding premium remittance:

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• The following premium fees are standard:

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           Terminal Liability: $2.00/pepm

           Monthly Accommodation: $1.50/pepm

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No commissions are payable on fees related to monthly accommodation.  

         

The premium may be remitted net-of-commission if so desired.  Please refer to the “Commission Payment Procedures” below for more information. (Back to Top)

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Commission Payment Procedures

 

The premium may be paid to MRM in two (2) ways: “gross” or “net-of- commission”.

Prior to the payment of any commissions due on the sale of stop-loss coverage through MRM, the producer must be appointed by the issuing carrier in the state where the case was sold. Therefore, no commissions may be withheld until the producer that sold the case is properly appointed. Once the appointment process is complete, we will release all commissions earned and future premiums may be remitted net-of-commission if so desired.

Please note that no commission is payable on fees relating to terminal liability and the monthly aggregate accommodation, thus, the premium remittance form does not allow entry for the withholding of commissions on these items.

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Reinstatement Procedures

 

All premiums payments are due on the first of each month with a grace period of 31 days from the first of the month for which premium is due. The coverage may terminate without further notice if payment is not received by the end of the grace period. In the event, the premium is not paid and the employer group’s grace period has elapsed the employer group may apply for reinstatement of Excess Loss Coverage.

 

Reinstatement procedures:

 

• The employer must complete Application for Reinstatement of Excess Loss Coverage

 

• The employer must pay all premiums due to the application

 

• The employer must provide experience by month, enrollment history by month and detailed shock loss data from the effective date to the end of the month previous to the date of the reinstatement request

 

• Additional information may be required; this may be determined by contacting the Director of Underwriting.

 

Monthly Aggregate Claim Reports:

 

Insureds that have purchased aggregate stop-loss coverage are contractually required to report total paid claims and single/family enrollment on a monthly basis. The accuracy of these reports is important, as this information is used in preparing renewal data information sent to you prior to the case anniversary date. In addition, this information is used when auditing the premium at the end of the contract period and in establishing aggregate claim reserves. Monthly Reports can be submitted by mail or e-mail.
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