Prodigy Health Insurance Services Contact

Summary

Prodigy is a full service Managing General Underwriter (MGU) headquartered in the Pacific Northwest. Our offices are located throughout the western United States.

Location: Freeland, WA 98249, WA, United States

Types of Insurance Return to search result

Employee Benefit Trusts:

  • Stop-Loss Insurance Services

Company Details

Our  offices are located throughout the western United States.  Prodigy understands the dynamics of regional challenges which face our broker and third party administrator (TPA) partners.

As a full service MGU, Prodigy provides medical stop loss coverage to self funded employers located through the country.  Our team of underwriters bring more than 100 years of combined experience in underwriting, reinsurance, compliance and risk management to each client we are privileged to serve.

So why use Prodigy?  Our name says it all…..something extraordinary, out of the usual course of nature.

At Prodigy, we are leading edge thinkers delivering innovative solutions based on time tested principles and an in-depth knowledge of medical risk management and loss mitigation.

Why work with an MGU?  As independent underwriters we have to earn your trust, therefore, we strive to deliver flexibility, quick turnarounds and creative solutions that are not typically available through direct writers.  Prodigy works closely with third party administrators, consultants and brokers in developing solutions through a variety of stop loss arrangements for their self funded clients. Our capabilities also include support of capitated networks, referenced based pricing, employer based captives and specialty carve-outs products.  At Prodigy, our stop loss policy is plan document friendly and we hold our claims payment capabilities to a higher standard than our competitors.

Medical Stop Loss

Medical stop loss or more appropriately, excess of loss coverage, is intended to provide self funded employer health plans with financial protection in the event of catastrophic loss. The concept is pretty simple…if a self funded plan has a large claim above its specific deductible, then the excess amount is reimbursed by the stop loss policy.  The simplicity ends when insurance carriers attempt to add sizzle to their products or control exposure through the addition of exclusions and limitations.

We believe that many of the policy enhancements including specific advance, monthly accommodation, terminal liability, no laser renewals, rate caps and multi-year rate guarantees add value though they are not without challenges or added cost to the health plan.  The specific advance and monthly aggregate accommodation may help an employer manage the organization’s reserves and cash flow.  Terminal liability can offer a low cost safety net to smaller employers which are considering a return to fully insured products.  Rate caps and rate guarantees are widely available yet do not offer the client any real protection against escalating costs.  Standard premium loads for renewal rate caps and multi-year rate guarantees continue to compound year over year and may result in mitigating the anticipated savings.  Like the others in the market, Prodigy offers many of these tools yet we encourage brokers, TPAs and employers to consider the financial impact when comparing options.

A stop loss policy is intended to reinsure the Plan Document yet many employers include ambiguous or poorly crafted language.  Therefore, it is important for brokers and TPA to compare the group’s stop loss policy with the Plan Document to ensure that gaps in coverage do not exist.  The inclusion of “mirroring” the underlying Plan Document is a great start. To fully protect employers, a review of the Human Resource policies may also be in order.  As a standard course of business, Prodigy mirrors the employer’s plan document.

The benefits covered under a stop loss policy will vary by group and could include medical, prescription drugs, dental and vision.  A specific or individual deductible is selected on a variety of factors include group size, financial capacity, provider network and historical claim experience.  The choice to add aggregate coverage as an overall maximum cost tool is a wise  move for small to mid-market groups.  The vast majority of larger employers recognize no need for aggregate coverage.

Prodigy offers our clients a range of stop loss solutions not commonly found in the reinsurance industry.  We encourage brokers and TPAs to contact our sales or underwriting team to discuss alternative strategies using captives, split deductibles, scheduled reimbursements or other flexible options.