Agmt96 Lipman - Laserfiche WebLink

Browse Search

Administrators Self-Funded Quote TIlE LIPMAN COMPANY, lNe. REPORTS: Claims Administration {Continued} 8. LOSS RATIO REPORT. Lists the attachment point and paid claim information by reinsurance code for each month in the aggregate policy year. This report can be printed by group or by group and plan, and is also available in a ratio or specific format. The following information is printed for each month in the policy year: single census count and attachment point, family census count and attachment point, sum of single and family attachment points, total paid claims accumulated toward to the aggregate limit, total paid claims not accumulated toward the aggregate limit and total paid claims. 9. FUND ACCOUNT STATEMENT. Summarizes all transactions for each fund along with the detail for each transaction. 10. CLAIM LAG STUDY BY BENEFIT. Summarizes the time difference between claim incurred and paid dates by the benefit type. 11. CLAIM LAG STUDY ANAL YSIS. Summarizes the difference between claim incurred dates and claim payment dates in dollars or percent of claim payments. LIABILITY: TLC Administrators will maintain in force for the term of the contract a fidelity bond in the amount of at least $250,000 to protect the p'lan against misappropriation and wrongful abstraction of funds and a comprehensive general liability policy that include errors and omissions coverage. We will hold harmless, defend and indemnify the plan from any loss arising from the performance of this agreement. The client will be provided with access to all information in our files for the purposes of claim verification and/or audit. FEES: The rates quoted in this proposal are guaranteed for one year. Fees for subsequent years will be subject to reasonable increases based on an analysis of actual costs during the preceding twelve month period. Appropriate annual or interim adjustments will also be made should the number of participants decrease materially. 8 -r-