Stop-Loss Policy Configuration, Contract Basis & Lasering
Track every policy term across every client; plan-year aware.
Policy Manager captures the stop-loss policy for each employer group — specific deductible, aggregate attachment point, contract basis (12/12, 12/15, 15/12, 24/12, paid), aggregating specific status, lasering and lasered members, terminal liability, estimated renewal premium, and expected reimbursements — and uses it to drive accurate scoring and projections.
Carrier, policy number, plan year, specific deductible, aggregate attachment point, contract basis, premium, and renewal date captured per employer.
Lasering flag and lasered member list tracked per policy; surfaced in scoring and renewal narrative for affected claimants.
12/12, 12/15, 15/12, 24/12, and paid basis captured and applied to how claims are attributed across plan years.
Estimated renewal premium, projected increase %, and expected specific / aggregate reimbursements feed the renewal view.
Carrier, policy number, deductibles, contract basis, lasering, and terminal liability are recorded per employer per plan year.
Policy terms feed the risk scoring engine; percent of deductible reached, and corridor burn are computed against real terms.
Estimated renewal premium, projected increase %, and expected reimbursements are computed from policy + claims trajectory.
Policy specifics (lasering, contract basis) feed the renewal narrative AI as structured context.
“Having every client's contract basis and lasers in one place ended our quarterly spreadsheet nightmare. Renewals are two-day events now.”