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Member Benefits
Self-Funded Large Group Market
Data Needed: If currently Self-Funded
Self Funded
Employee Census to include (must have these elements):
Dat of Birth (MM/DD/YYYY)
Gender (M/F)
Zip Code (5 digit)
Plan Election
Tier Election (EE, EE+SP, EE+CH, EE+CHILDREN, FAMILY)
COBRA Indicator (Y/N)
Retiree Indicator (if applicable)
24 months of Monthly Medical Claims Data (Aggregate Reports are acceptable), by Plan Year
Minimum of 12 months, up to 24 months, Rx claims detail for Rx repricing, by Plan Year (please include Rx Rebates received for same time-period)
Monthly Enrollment Data that matches up with medical/rx data, by Plan Year
Current Stop Loss Policy Information (please provide a copy of the current policy)
Large claims data, including diagnosis information, that coincides with the monthly claims data (should cover same time periods as monthly data)
Renewal Year Rates +2 Prior Years Rates
Current and Renewal Plan Design Details (Including any requested future changes) - Schedule of Benefits is preferred
Enter the information above into the form below and send your data contents as specified by group size to CAM@varipro.com
Click Here to access form