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Fully-Insured Transplant Policies

The Sensible Solution for Rising Catastrophic Transplant Costs for Self-Funded Employers

Provides the insured with first dollar coverage* and helps to:

  • Avoid Lasering
  • Protect Stop Loss Rates
  • Improve Cash Flow of Claims Fund
  • Provide Top Level Medical Services

A transplant can hit any group at any time. For self-funded employers, it can have a devastating impact on stop loss insurance and the bottom line.

Facts:

  • The number of transplants has risen significantly in the past 10 years
  • There are 3 times more people waiting for a transplant than 10 years ago
  • Medical trend and transplant technology costs aren’t getting any cheaper
  • Average transplant cost exceeds $250,000
  • 40% of all stop loss lasers are due to transplants

Solution:

Diversified Group offers a simple solution to transplant exposures for self-funded employers. By “carving out” transplant exposures from a benefit plan, employers can control the catastrophic costs associated with transplants and reduce them to a budgeted per employee per month rate. This policy, which includes generous benefits that can fit with any employer’s self-funded health plan, is provided by Medical Excess.

Policy Highlights

  • $1 million lifetime maximum ($2 million available)
  • 100% coverage for all in-network transplant-related claims from first dollar* (including hospital, physician, procurement and drugs)
  • Experienced transplant case coordination
  • Choice of some of the finest transplant centers in the U.S.
  • Generous travel and lodging expenses for patient and one companion
  • Benefit period covers evaluation through 365 days post transplant operation
  • Policy language that is easy to understand
  • Covers all major organ and tissue transplants:
    • Heart
    • Pancreas
    • Heart/Lung
    • Kidney
    • Lung
    • Kidney/Pancreas
    • Liver
    • Small Intestine
    • Bone Marrow
    • Stem Cell

Advantageous Coverage

Employees will especially benefit from this coverage in that there are no deductibles or co-insurance.

  • Patients receive the finest care available from the most reputable transplant centers in the country
  • Nationwide transplant network available to fit the geographic needs of the employer
  • One simple, affordable rate per employee provides plan stability, and also reduces the employer’s stop loss and out-of-pocket expense
  • Transplant providers are paid directly, thus avoiding cash flow drainage on the employer’s health benefits trust
  • Exclusive to Diversified Group Brokerage Corporation clients of 50 or more employee lives.

* For individuals covered under a High Deductible Health Plan (as defined by the IRS), the Health Plan’s high deductible must be met before benefits will be provided under the Transplant program

For more information, or to obtain a comparison, contact a Diversified Group Sales Representative at 888-322-2524 today.

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