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The National Labor Alliance of Health Care Coalitions works with its member coalitions and its Product Development committee to form strategic partnerships and alliances with organizations which provide advantages in service, quality and cost to participating funds. The NLAHCC works with experts to conduct RFIs which provide a due diligence for participating funds. The methodology and results are shared with member coalitions. (See our Member Entrance section.)

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NLA Advantage - Medical Stop Loss

Overview

The NLA Advantage has been developed by the National Labor Alliance as an opportunity for funds that have changed annual limits due to (PPACA) health care reform and others that purchase Medical Stop-Loss. The NLAHCC has provided an exclusive stop-loss program in partnership with Knight International and HCC Life. The program has been designed to limit operating expenses and profits keeping the cost low and taking a hand-on approach on protecting the funds bottom line.

Services Offered:

  • Early Lock out (6 months before effective date)
  • Discount to manual rates
  • Premium Holiday for positive results
  • Access to an array of claim units and other valued services (see handouts)
  • Each fund will be underwritten on own merits
  • Access to Transplant networks

Quality and Savings:

The NLA Advantage allows each fund to benefit in the success of a larger pool and also allows funds to be evaluated and underwritten with their claims history.

Medicare is reimbursing less and the cost and frequency of catastrophic events continues to rise. This creates an environment to shift the costs to Health and Welfare funds. With the backing of HCC Life and knowledge of Knight International funds will be able to proactively manage claims and provide a sustainable plan of action for limiting liability on the Health plan.

Quote Submission Checklist

  • Official name of the employer
  • Location of the group (city, state, zip code, number of employees at each location for multi-location groups)
  • Desired effective date of coverage
  • Quote due date (date due to you)
  • Current, legible census (including year of birth or age, sex and type of coverage. If COBRA or retirees please mark accordingly.) Electronic submission (Microsoft Excel format) is preferred. If the employer has multiple locations, HCC Life requires the number of employees at each location with corresponding zip code
  • Type of industry (for SIC purposes)
  • Schedule of the current benefits and requested benefits, if different. Note what coverage is to be included under the specific and/or aggregate
  • Monthly claims (month-by-month aggregate report, including number of employees by month for the most recent 24-month period (minimum))
  • Shock claims in excess of 50% of the current deductible or any serious ongoing condition by diagnosis and prognosis
  • If a PPO Network is being used, what network? If multiple networks, please indicate by location
  • What UR vendor will be used?

Downloadable PDFs

Primary Contact

For additional information please email stoploss@nlahcc.org or contact Ruth Gillan, Director of Employee Benefits and Taft Hartley, at (781) 966-3708.

 
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