HMO REINSURANCE AND PROVIDER EXCESS OF LOSS COVERAGE The Physicians Advocate, LLC is a broker exclusive to the healthcare industry. We are also one of the few experts in Florida that negotiates and secures HMO Reinsurance / Provider Excess of Loss insurance to Managed Care Entities that assume global capitation risk. Our many clients include: HMO’s Physician Practices IPA’s PACE program participants There are many variables to consider when assuming the correct structure for your HMO Reinsurance / Provider Excess program such as rate, the appropriate attachment point, and what services to include and exclude from coverage. There is a limited list of insurers that specialize in providing this coverage. The Physicians Advocate, LLC represents the seven (7) leading insurers representing over 90% of all placements in the United States. We work with Medicare, Medicaid and commercial populations. We have also structured programs for specialty carve-outs situations such as behavioral and pharmacy benefit niches. If you are buying Stop Loss coverage from your contracted HMO’s, you are probably paying a lot more per member per month (“PMPM”) than if you worked with the commercial market. For every client we have pulled out of an HMO’s plan for this risk, our clients have enjoyed considerable savings. If you are already insured by the commercial market, are your terms competitive? We’ll provide a free analysis of your current program and evaluate: o If your current thresholds are most cost-effective; o Do sublimits hinder your maximization of claim reimbursement; and o The competitiveness of your current rates. We welcome the opportunity to represent you. Feel free to contact my office at your convenience. ChristopherPrestera, Prestera, JD, CPCU Christopher CPCU, CEO Cell: (954) 336-7284 CEO [email protected] Email: [email protected] Ph:(954)491-8052 Fax: (954)4918063 th 6301 NW NW 5 th Way, Suite Suite 2800 2800 6301 5 Way, Fort Lauderdale, FL 33309 Ft. Lauderdale, FL 33309 Ph: (954) 491-8052 | Fax: (954) 491-8063
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