HMO Reinsurance

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HMO Reinsurance

HMO Reinsurance should be considered by Managed Care Organizations who are financially responsible for the cost of medical services. Limits available typically range from $250,000 to $2 million per member per year. The insurance company will pay up to a maximum limit specified in the policy on behalf of the Insured any Loss that the Insured is legally obligated to pay as a result of any covered claim for a professional services wrongful act.

Policy options and benefits may typically include:

  • Insolvency Coverage
  • Coverage available for start-up’s
  • Alternative funding arrangements available, including retro funding and inner aggregate funding
  • Flexible Retentions per member per year for Physician coverage and per member per year for Hospital coverage
  • High excess options with no Average Daily Maximum available

Claim management services may be a differentiating factor. Good programs may include:

  • Access to physician review and referral services
  • Access to network management services, including out-of-area networks, wraparound plans, national transplant networks and neonatal networks
  • Access to financial management services, including bill review and re-pricing services, subrogation services and fraud and abuse identification and protection
  • Access to a nurse consultant for assistance with cost containment programs and services

Fill out and submit the contact form on this page, or call Oros Risk Solutions today at 1-866-596-3859 to arrange to speak with one of our knowledgeable specialists about HMO Reinsurance.