This has bothered me for awhile.
For an employer purchasing a 12/12 contract do they essentially concede that incomplete claims as of 1/1 from November and December will not have stop-loss coverage? Do they therefore try to pay claims more quickly towards the end of the stop-loss contract period?
As I understand it, even if the employer renews the stop loss contract to another 12/12, any claims from the prior period paid in the current period will not be subject to stop-loss. This just seems like a crappy deal for the employer.
Maybe the anti-selection that the mate card refers to with 12/12 and 12/15 contracts is that company's choosing a 12/12 will try to pay November and December claims more quickly then January-October. So applying the 12/15 lag pattern to a 12/12 contract would be inappropriate.
For an employer purchasing a 12/12 contract do they essentially concede that incomplete claims as of 1/1 from November and December will not have stop-loss coverage? Do they therefore try to pay claims more quickly towards the end of the stop-loss contract period?
As I understand it, even if the employer renews the stop loss contract to another 12/12, any claims from the prior period paid in the current period will not be subject to stop-loss. This just seems like a crappy deal for the employer.
Maybe the anti-selection that the mate card refers to with 12/12 and 12/15 contracts is that company's choosing a 12/12 will try to pay November and December claims more quickly then January-October. So applying the 12/15 lag pattern to a 12/12 contract would be inappropriate.
Stop Loss 12/12 ctc
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