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Stop Loss Presentation

  1. The Symetra & Crowne Advantage
  2. Our Commitment to YOU!
  3. Broker Service Capabilities
  4. Reporting
  5. Renewal
  6. Case Studies
  7. $22.4 billion in assets as of 12/31/09 with revenue of $1.7 billion
  8. A.M. Best Rating: A “Excellent”
  9. Fitch Rating: A+ “Strong”
  10. S&P’s Rating: A “Strong”
  11. Over 100 years of combined industry experience serving public and private organizations and their respective employee benefits advisors & consultants
  12. Stability of an active ownership/service team
  13. Business model built on service, expertise & integrity
  14. Fast, accurate specific claims reimbursement typically within 7 days of claim filing.
  15. Medical Management nurses partner with your TPA to reduce ongoing claims costs
  16. No audit policy on mainline carriers
  17. A “no laser” policy upon renewal
  18. Now offering 2nd year rate caps for qualified groups
  19. Crowne leverages our $14 million book of business to bring independent agents and their clients best in stop loss pricing
  20. Crowne also leverages our volume and relationship with Symetra to the clients advantage in claims adjudication, timely reimbursement and contract provisions
  21. Our commitment is to NOT pursue any existing client for any insurance coverageswithout prior approval
  22. Crowne believes we can be more successful working in partnerships rather than working in competition
  23. Crowne will commit to always communicating with you unless otherwise directed
  24. Data Gathering , Preparation and Submission to Symetra
  25. Crowne performs initial negotiations w/Symetra based on submittal and market conditions
  26. Proposal Preparation and Delivery to YOU!
  27. Crowne will perform Best and Final negotiations and assist with carrier negotiations if necessary
  28. Agent collects deposit, all signed agreements from client and returns package to Crowne for processing
  29. Case file w/policy# is completed. Policy issued and return to agent for delivery
  30. Report File is built (See slide 11 for details)
  31. Crowne forwards completed claim file to Symetra Claims via overnight or email
  32. Crowne monitors claim processing…typical claim payment within 5 days of claim adjudication
  33. Reimbursement check is delivered to Crowne via overnight or mail and delivered to agent unless otherwise directed
  34. tracks claimants who have reached 50% of Spec Ded., monitored monthly
  35. Claims Reimbursement Summary
  36. tracks on-going spec claimants monthly
  37. Aggregate Reporting (if group purchases Agg. coverage)
  38. Monthly Aggregate Liability Report
  39. Includes Aggregate Funding Factors, enrollment, monthly Max. claims funding, monthly actual claims results, and YTD loss ratio)
  40. Total Monthly Fixed Cost Report (current )
  41. Total Monthly Combined Cost Report (current claims & fixed costs)
  42. Total Combined Summary Report (prior period)
  43. Preliminary Renewal Analysis w/Funding Options
  44. Savings Analysis for Plan changes
  45. By line of coverage and summary level
  46. Key Indicators Report (current & prior periods)
  47. Pharmacy Utilization Reports
  48. Symetra prepares renewal proposal
  49. Crowne delivers renewal to agent
  50. Crowne negotiates a satisfactory renewal with Symetra
  51. The $800K claimant passed through the end of contract and through the run-out period (12/15) prior to claim being filed
  52. Crowne intervened on behalf of agent and client to perform claim audit
  53. By contract, Symetra had no liability to pay claim
  54. Crowne leveraged its negotiating power with Symetra to have claim adjudicated and paid according standard contract language
  55. After the group moved to a self-insured arrangement with a carrier with superior network discounts, Symetra & Crowne delivered back-to-back single digit increases
  56. Crowne was brought in within days of the accident to assist in negotiations with the carrier and medical providers to extend standard contract benefits at negotiated contract pricing at local providers
  57. Crowne further negotiated with Symetra by leveraging its book of business to ensure the extended benefits and negotiated rates were to be covered under the stop loss contract
  58. Provide extensive day-to-day stop loss service including claims filing, reporting and data analysis
  59. Crowne’s leverage of their book of business for the best in stop loss pricing and claims adjudication
  60. Highly favorable contracts and stop loss experience