Group Underwriting Flashcards
1
Q
Group Underwriting
ACA Program Design Considerations
A
- AV of at least 60%
- Minimum Essential Coverage (MEC)
- Affordable coverage (9.5% of income)
- Cadillac Tax
- Impact of Public/Private Exchanges
2
Q
Group Underwriting
ACA: Impact of Exchanges
A
- Public
- EEs can leave ER coverage and get coverage on public exchange
- Large ERs can fund account for EEs to obtain coverage
- Private
- Creates antiselection risk because it allows more choice for EEs
3
Q
Group Underwriting
New Business Underwriting: Group Characteristics
A
- Age/Gender
- Industry
- Area
- Financial Stability
- Ease of Admin
- Level of ER subsidization
- Participation
- Carrier Persistency
- Little emphasis on health status of individuals
4
Q
Group Underwriting
Considerations when Developing Large Group Proposal
A
- RFPs are lengthy
- Plan Design
- Funding Arrangements
- Enrollment Patterns
- Performance Guarantees (speed of claims processing, customer service)
5
Q
Group Underwriting
Large Group Renewal Underwriting
A
- Evaluating case
- Enrollment change
- Antiselection
- Catastrophic claims
- Admin
- Developing renewal recommendation (new premium, alternate funding methods)
6
Q
Group Underwriting
Underwriting Group Disability
A
- Claims are subjective and volatile
- Classify groups by occupation and industry
- “Over-insurance” must be avoided
- Firms with history of high turnover = higher risk
- Non-contributory plans = desired
7
Q
Group Underwriting
Underwriting Group Life
A
- Experience rating based on several years of experience
- Consider risks of benefits in retirement or terminal illness
