It’s almost renewal time; do you know where your claims data is?

Years ago, a similar question was asked in a PSA on television. It admonished parents to know what their children were up to late in the evening. Knowledge is power as the saying goes. The same applies to the performance of a group health insurance plan. Insurance companies apply the financial results of your plan, known as Claims Experience, to varying degrees in the formulation of pricing. If you have insight into Claims Experience, you have insight into what to expect and how to plan for the next renewal.

Large employers tend to have fairly easy access to this data. For smaller employers it may be trickier. Either way, your broker/advisor ought to be monitoring the results and sharing them with you along with analysis and insight into drivers of results and recommendations for action.

In Texas, all employer sponsored group plans are entitled to Claims Experience per HB 2015. At renewal and one other time per year, insurers must supply total paid claims as well as details of any claims in excess of $15,000. There is a formal request process and insurers have 30 days to respond so it is important to be proactive. Each insurer uses a slightly different form. If you need help with this part of the process please let me know and I will be glad to assist.

Insurance rates keep rising but there is no reason to be surprised and forced to make hurried decisions. Insurers are managing your money and lots of it. Be sure to take full advantage of every resource available to make sure you’re getting the best possible results.


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