HMO Reinsurance & Provider Excess Of Loss Insurance

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
Chris@phyadv.com
Email: Chris@PhyAdv.com
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