- Company location
- Nature of business (SIC Code)
- Proposed effective date, and due date
- Provide details if there is more than one location
- Complete Excel census including year of birth, gender, coverage status (single/family), zip codes, COBRA/Retiree status
- Current schedule of benefits as well as any proposed benefit changes. Current Managed Care Network and any proposed changes to the Managed Care Network
- Month-by-month claims and enrollment. (Minimum – 19 months. Preferred – 36 months). Large claim information corresponding to the month-by-month claims.
- Current and/or renewal rates.
Also, please provide current funding mechanism, current/requested specific deductible, current/requested contract types, current/requested commission level, and any other pertinent information necessary to provide our most competitive terms. For groups that are currently fully insured, please provide a rate history, including renewal rates, as well as any experience exhibits that are available.
Underwriting Information and Procedures
Underwriting Forms and Agreements