Fully Insured Large Group Market

Data Needed if currently Fully Insured (Large Group Market) or currently Level Funded with claims data available

• Member Level Census REQUIRED, and to include (must have these elements, no middle initials or suffix):
  
  • First Name
  • Last Name
  • Gender (M/F)
  • Date of Birth (MM/DD/YYYY)
  • Zip Code (5 digit)
  • State (XX)
  • Subscriber Relationship (Subscriber, Spouse, Child, Legal Dependent)
  • Tier Election (EE Only, EE+Spouse, EE+Child(ren), Family, Waived, Waiting Period, Not Eligible, Refusing Coverage)
  • COBRA Indicator (Y/N)
  • Plan Election (if more than one plan must be included)
  • Retiree Indicator (Y/N)
    
    
• Renewal Year + 2 Prior Year Rates (must include a copy of the Carrier renewal proposal for each year)
• Current and Renewal Year Plan Design Details, please send in Schedule of Benefits and note any requested future plan changes
• Claims data to include:
  • Minimum 12 months of Monthly Medical & Rx Paid Claim Data, run by Plan Year dates
  • Monthly Enrollment Data (should cover same time period(s) as monthly claim data)
  • Large claims data including any member with claims paid @ 50% of requested Spec level, include total paid claims, diagnosis, and prognosis (if available) (should cover same time period(s) as monthly claim data)
    
    

Enter the information above into the form below and send your data contents as specified by group size to CAM@varipro.com