6 Risk Analysis

Planwatch Risk Analysis enables TPAs to quickly and securely share health data information with excess risk insurers/MGUs for medical stop-loss underwriting.

Most stop-loss carriers require an employer disclosure before providing a new or renewal quote. A typical disclosure lists all known participants that have exceeded a given dollar threshold, have received certain diagnoses, or that are known to be high risk / complex care. The depth of data required and the process of disclosing this information is continuously evolving. Planwatch has adopted the SIIA and SPBA endorsed standardized disclosure form and ICD codes set.

In addition to the disclosure listing and drill down capabilities, Risk Analysis includes active census and historical claims reports.

  1. 6.1  Running New Risk Analysis Reports
  2. 6.2  Disclosure Listing
  3. 6.3  Disclosure Drill Down
  4. 6.4  Active Member Census
  5. 6.5  Age Banded Census
  6. 6.6  Claims and Lives by Month