Fully-Insured Transplant Policies

POWERFUL COST CONTROLS

This program provides long term rate stabilization to self-insured health plans. We understand that the complexity and costs surrounding a transplant claim are a concern for self-funded employers, especially those that are fewer than 300 employees. To address this, we have incorporated a simple solution to transplant exposures. By fully insuring our transplant coverage, we can effectively “carve out” transplant exposures from a benefit plan.

Fully-insured transplant policies provide the insured with first dollar coverage* and help 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 and it can have a devastating impact on stop loss insurance and the bottom line.

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

Our Simple 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 includes generous benefits that can fit with any employer’s self-funded health plan.

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

DIVERSIFIED GROUP
BROKERAGE

Phone: 888-322-2524
Fax: 860-295-6579

DIVERSIFIED ADMINISTRATION COPORATION

Phone: 888-322-2524
Fax: 860-295-6579

CORPORATE MANAGED HEALTH SERVICES

Phone: 800-423-5597
Fax: 860-295-6145

CORPORATE FITNESS & HEALTH

Phone: 800-423-5591
Fax: 860-295-1239
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