RSSCategory: Underwriting/Admin

What is Cost Plus?

Definition of a cost plus claim and the associated fees, taxes and legislative rules.

Underwriting: Fully Pooled

Fully pooled is a fully insured underwriting method typically used for smaller groups as well as those benefits that have a low incidence of claim but a high claim amount irrespective of size. Typical for out-of-country and accidental death and dismemberment benefits as well as Basic Life and Long Term Disability for smaller employer groups.

Underwriting: Refund-Accounting

A group that uses the refund accounting underwriting arrangement to fund it’s plan is essentially prospectively rated however choosing to share in the financial results of the program through an annual accounting of surplus/deficit completed by the insurer.

Underwriting: Prospectively Rated

Prospective rating is similar to fully pooled in all aspects except premium renewal rating. The key difference lies in that prospectively rated groups have a either a portion or all of their claims experience used in determining premium rates. Renewal rates are determined by reviewing historical claims experience and then applying the rate adjustment prospectively or to future policy periods.