Fully-Insured Transplant Policies

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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
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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

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DIVERSIFIED ADMINISTRATION COPORATION

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

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CORPORATE MANAGED HEALTH SERVICES

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

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CORPORATE FITNESS & HEALTH

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