EBMS has successfully administered self-funded benefit plans for more than twenty-five years, positioning itself as a leader within the industry.  Our expert staff understands how self-funding can be one of the most effective tools for managing healthcare benefit expense. EBMS is also acutely aware of the nuances of self-funding, including the associated risks involved. While our clients are able to partially protect their Plan through the purchase of stop-loss insurance, EBMS is not satisfied with the stop-loss products available in the marketplace. “Poor Practices” within the stop-loss insurance industry will likely present many Plans with a variety of potentially serious challenges. To specifically name a few: •   Individual underwriting at renewal versus pooled underwriting. This can result in significant premium increases should a group develop unfavorable claims experience in any given year •   Lasering at renewal. This practice transfers large claim liability from the insurance carrier to the self funded plan •   Slow turnaround time on stop-loss reimbursements •   Costly operating expenses and sizeable profits retained by stop-loss carriers EBMS is very pleased to be able to provide its clients with a Solution to these challenges through its development of a very unique stop-loss program.   EBMS Re  Our stop-loss product was developed exclusively for EBMS clientele. This Solution was introduced to provide EBMS clientele with superior stop-loss coverage sold at cost. Efficiencies allow us to operate our stop-loss program at approximately half of the industry average. Further, our stop-loss program offers the protection of true pooled underwriting, and will never engage in the practice of “lasering.”   The whole is greater than the sum of its parts. This is evidenced through the synergies gained when employers participate in EBMS’ stop-loss program. Through our stop-loss program, employers fully pool their premiums, which enables them to evenly redistribute their risk. Thereby, offering additional protection to each participating employer against a year wrought with large claims expense.   Our fully pooled stop-loss product provides clients with the following synergies: •   Stop-loss premiums are stabilized. This assists our participants with the fiscal management of their Plan. •  There is no individual underwriting or lasering at renewal. •  All profits generated in this program are returned to each Plan in the form of a premium credit upon renewal. •   EBMS’ internal claims management system provides efficiencies in stop-loss claims reimbursement, which negates the need for our stop-loss carrier to  spend additional time reviewing   reimbursement decisions.   Our Underwriting Approach EBMS’ philosophy is quite different than other carriers. We carefully analyze claims data in order to provide clients with a quote which considers long-term costing up front. Our primary goal is to provide a stop-loss product which will stabilize stop-loss premiums through pooling. This practice eliminates the large fluctuations in stop-loss premiums that companies like yours may have been experiencing. This is a practice unique to our stop-loss product. Pooling also provides an additional layer of coverage not found in today’s stop-loss market. Stop-loss contracts are written for one year. Recent industry practice is that underwriters only consider health outcomes for this one year time period.This may allow for a slightly reduced premium initially, but will likely produce a drastic increase, or laser at a renewal somewhere down the line.   Premium Credits At the end of each underwriting year, we produce a profit/loss statement for the stop-loss program. Profits earned are dispersed as renewal premium credits to the program’s participants who generated them. ALL surplus dollars are disbursed back to these participants at their renewal following the completion of each underwriting year.   Protecting Our Employer Groups Our program purchases excess-loss reinsurance to further ensure our financial solvency. We retain a “specific” corridor of risk of $200,000 above the employer’s individual specific deductibles. Following which, our reinsurance partners take 100% of the remaining risk up to each of the employer’s Plan’s maximums.   To determine if our stop-loss program makes sense for your organization, contact:   Rod Kastelitz, Vice President, Sales & Marketing   800.777.3575, ext. 1241     or   Mark Smidt, Director of EBMS Re   208.939.7117