Stop Loss Administration

Dedicated contract analysts and Home Office service representatives ensure superior service for our TPAs and employers.

Contract issuance

Once the underwriting process is complete and the group sold, we require the following for policy issue:

• Signed original application *
• Binder premium *
• Signed addendum *
• Plan document
• Original select risk questionnaire
• Any other information addressed in the proposal

Once all information has been received, our goal is to issue the policy within 10 working days.

TPA requirements

For a policy to be issued, the TPA must have an agency license, the TPA's employee must have an agent's license, and both must be appointed with Mutual of Omaha and/or United of Omaha Life Insurance Company, with a signed producer agreement. These requirements also apply to any outside broker the TPA may use.

A number of states require TPAs to have an Administrator license or TPA registration license.

Premium administration

Premiums are due by the first day of the policy month (period of coverage). A grace period of 31 days is allowed; however, coverage terminates as of the premium due date if the premium is not received by the end of the grace period.

Policy termination

Policies continue in effect until the end of the policy period, or:

• The date the self-funded plan terminates
• The date the employer group dissolves, suspends business operations, or is placed in bankruptcy or receivership
• The later of the date we receive written notice of termination or the termination date requested
• The date described in the Premium Rates, Deductibles and Factor Changes provision of the policy
• The date a change in any policy deductible, deductible factor or premium rate is effective, but has not been accepted in writing
• The premium due date, if premium is not paid by the end of the grace period
• Other circumstances stated in the Stop Loss policy

If a policy terminates for any reason, it may be reinstated at our option. The policy can be reinstated only in writing by one of our officers and must be subject to any written reinstatement conditions we impose. Contractually, Mutual of Omaha has no obligation to reinstate a lapsed policy.

Form 5500

ERISA requires each employer/client to complete a Form 5500. The form reports various insurance transactions that occur within a given plan year. Information required in the filing includes premiums paid, commissions paid, and other fees or overwrites paid.

Unless otherwise requested, we supply the required information to the TPA for employer groups of 100 or more lives within 60 days after the plan year ends.

Contact Us

For more information about our administration processes or TPA Stop Loss products, submit a request.