Underwriting Results Of A Mid-Size Self-Funded Health Plan
NOTE: This article is dedicated to the memory of Charles Proteus Steinmetz.
Amazing things can happen when you pay attention. The graph above illustrates the results one can expect when a plan sponsor replaces an insurance consultant who wasn’t paying attention with one who does.
In this case the group hired a new consultant effective January 1, 2025. It took the consultant five minutes to find a solution. It took the plan sponsor 60 days to implement it.
The reduction in the plan’s paid loss ratio shown above was not the result of changing benefit design or applying Magic Dust. It was the result of something else. Something basic.
Enforcement of Plan Document language and synchronization of vendor contracts is essential. All must be interlaced, meshed. When one contradicts the other problems will inevitably arise placing both plan sponsor and plan members at unnecessary risk. This was the case in this instance.
The group’s return on investment to date has proven out by way of a Charles Proteus Steinmetz factor of +10 powered by a strongly held belief that “There’s no such thing as an unsolved problem.”
