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Frequently Asked Stop Loss Questions

• What are Mutual of Omaha's Financial Ratings?
• What is Mutual of Omaha's underwriting and laser strategy?
• When does Mutual of Omaha evaluate large claimants?
• How does Mutual of Omaha define a "Paid" claim?
• When will Mutual of Omaha bind a case?
• Does Mutual of Omaha offer a Terminal Liability option?
• What run-in limits does Mutual of Omaha apply to the Specific and Aggregate contract?
• What size groups does Mutual of Omaha prefer to write? Is there a minimum?
• Does Mutual of Omaha take into consideration any other pricing factors when evaluating a case?
• What types of groups does Mutual of Omaha prefer to write? What industries are ineligible?
• What TPAs are approved?

What are Mutual of Omaha's Financial Ratings?

A: A.M. Best Company A+ (Superior)
Moody's Investors Service Aa3 (Excellent)
Standard & Poor's AA- (Very Strong)

Ratings as of December 2007

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What is Mutual of Omaha's underwriting and laser strategy?

A: For Specific coverage, our underwriting focuses on the demographics of the group and the incidence of specific claims vs. the expected number of claims. The Aggregate is evaluated based on a blending of demographics and claims experience.

In addition to other underwriting options, Mutual of Omaha may laser individuals when underwriting new business. Upon renewal, we will not laser high-risk claimants unless coverage was initially sold on that basis and the need for the laser continues. Mutual of Omaha will present a variety of renewal options, including lasers, if requested by the TPA/employer.

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When does Mutual of Omaha evaluate large claimants?

A: Large claimants are evaluated during the initial underwriting process.

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How does Mutual of Omaha define a "Paid" claim?

A: A 'Paid' claim is defined as one that has been processed. With specific accommodations, a draft/check must be delivered to the payee within ten days after receiving the specific accommodation.

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When will Mutual of Omaha bind a case?

A: We will bind a case after receipt and approval of the disclosure statement and application. We typically bind a case 45 days prior to the effective date. Special considerations are given to groups that are effective on January 1 or July 1.

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Does Mutual of Omaha offer a Terminal Liability option?

A: Specific and Aggregate terminal liability are available as a rider.

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What run-in limits does Mutual of Omaha apply to the Specific and Aggregate contract?

A: For Specific coverage, we require a run-in limit equal to the Specific deductible. This can be waived upon receipt of current claim information. We require a run-in limit of 15 percent of the annual attachment point for the Aggregate.

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What size groups does Mutual of Omaha prefer to write?
Is there a minimum?

A: Our target market is 100 + lives; however, on an exception basis we provide quotes for groups under 100 lives.

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Does Mutual of Omaha take into consideration any other pricing factors when evaluating a case?

A: When evaluating a particular risk, we consider PPO discounts, penetration and all other cost containment measures.

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What types of groups does Mutual of Omaha prefer to write?
What industries are ineligible?

A: Acceptable – Financially stable companies that have been in business for at least two years and have low employee turnover, minimum 50 percent participation and demonstrate some degree of carrier loyalty.

Ineligible – Hospitals, long haul trucking, MEWAs, METs, PEOs, associations, mining, explosives, leather tanning, asbestos products, taxicabs, eating and drinking places, liquor stores, hotels and other lodging and amusement and recreation except movies. These ineligible industries may be considered on an exception basis based on unique circumstances of the individual group.

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What TPAs are approved?

A: Contact your local sales representative for a list of administrators approved through Mutual of Omaha.

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Contact us

For more information about our TPA Stop Loss products, submit a request
or call (402) 351-3932.