Excess Loss Insurance

Protection from Unexpected High Dollar Claims SafeGuard offers built-in aggregate excess loss insurance coverage which protects employers from unexpected high-dollar shock claims Within each monthly payment, the employer pays excess loss insurance premium for coverage spanning the twelve month contract period The pre-funded claims account represents the maximum financial obligation the employer will face for covered medical claims The excess loss insurance coverage pays all claims beyond the pre-funded claims account annual total

Excess Loss Insurance Premium The employer’s monthly payment remains fixed, as long as the census remains unchanged An amount is collected monthly for the excess loss insurance premium and the administration fee– these are the plan’s fixed costs The portion of the monthly payment collected for the pre-funded claims account represents one-twelfth of the employer’s aggregate claim liability– the annual sum of these payments is the maximum financial obligation the employer will face for covered medical claims

Excess Loss Insurance Payments and Aggregate Advances When a high-dollar claim happens early in the twelve month contract period, exceeding the present pre-funded claims reserve account balance but falling below the anticipated annual balance of this account, an aggregate advance is made to cover the claim Aggregate advances are advances against future pre-funded claims reserve account contributions and are reconciled at the time of settlement Excess loss insurance payments begin where aggregate advances end– i.e. the point at which the annual pre-funded claims account balance “threshold” has been reached By combining aggregate advances and excess loss insurance coverage, SafeGuard ensures that the employer will never pay more than the twelve level, scheduled payments for covered medical claims

Incurred Contract SafeGuard is an incurred-contract program– covered, eligible claims incurred during the twelve month contract period will be processed for payment according to plan guidelines The contract settlement period extends 90 days beyond the twelve month contract end date in order to allow time for incurred but not reported (IBNR) claims to reach USHL for processing Excess loss insurance coverage will remain in force to cover IBNR claims– received beyond the contract end date In cases of early terminations, employers must continue to pay the pre-funded claims account portion of the monthly billing for the duration of the contract period in order to keep excess loss insurance coverage in force for claims incurred prior to the termination date

SafeGuard Cash Flow Mechanics The illustration below details the cash flow within a SafeGuard high-cost claims year when both aggregate advances and excess loss insurance payments will be made:

SafeGuard Excess Loss Insurance Contract The SafeGuard excess loss insurance contract is between USHL and the employer, and establishes coverage for the twelve month incurred contract period The application for excess loss insurance coverage is a component of the SafeGuard new business document processing A tremendous advantage of SafeGuard is that the excess loss insurance coverage is same-source– because USHL is both the administrative services provider and excess loss insurance carrier, payments from the excess loss insurance coverage happen as they are needed and the employer is never required to pay a spike in claims or a shock claim up front and await reimbursement from a third party

For additional information on SafeGuard, select an option below: Speak with a Sales Representative Contact USHL Sales Support at (844) 828-5968 or send an email to SalesSupport@ushealthandlife.com Learn more about SafeGuard http://www.ushealthandlife.com/Find-a-Plan/Medical/SafeGuard Review SafeGuard Benefit Summaries http://www.ushealthandlife.com/Find-a-Plan/Medical/SafeGuard/Benefit-Summaries Review Frequently Asked Questions http://www.ushealthandlife.com/Portals/0/Documents/SafeGuard/SafeGuard_FAQs.pdf Obtain a Quote http://www.ushealthandlife.com/Find-a-Plan/Quotes-from-USHL/Get-a-Quote#SafeGuardQ Excess loss insurance policies and PPO insurance plans underwritten by US Health and Life Insurance Company, Inc.  SafeGuard plans administered by US Health and Life Insurance Company, Inc. © 2017 US Health and Life Insurance Company, Inc. All rights reserved.

Excess Loss Insurance