How It Works

For Self-Insured Employers

Upon meeting membership eligibility requirements, self-funded plans of all sizes can access affordable supplemental stop-loss insurance designed specifically to manage pharmacy risk. The unique solution limits the amount that a plan or its stop-loss carrier are required to pay to safeguard against unexpected and potentially catastrophic specialty claims.

Insurance brokers will assist their self-insured employer clients in completing a brief enrollment process to enter into the supplemental stop-loss captive program in order to receive coverage. The Captive Enrollment Process is sponsored by Marsh Affinity, which works directly with each self-insured employer to provide policy documents and claims reports and assist with streamlined payment processing.

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Captive Enrollment Process

Submission

Certified insurance broker recommends interested self-insured employer.

Review

Employer reviews the Captive Enrollment Agreement and Specimen Policy.

Connect

The RxPharmacy Assurance Service Center managed by Marsh Affinity sets up a time to answer any client questions and finalize enrollment.

Sign

Employer will digitally sign and accept coverage, as well as provide preferred ACH payment details.

Feel Secure

After the enrollment process is complete, the employer can reap all the coverage benefits and feel protected against catastrophic claims.

Claims
Procedure

Self-insured employers will receive notice from RxPharmacy Assurance once an individual has exceeded $250,000 in plan cost for a qualified condition and eligible therapies. At this time, self-insured employers may submit a claim for validation and payment in accordance with the terms of the policy. Once a claim is filed, RxPharmacy Assurance will validate compliance with the terms of the agreement.

About RxPharmacy Assurance

RxPharmacy Assurance, Inc. is a Vermont domiciled Sponsored Captive managed by Marsh Captive Management. Upon meeting membership eligibility requirements, self-funded plans of all sizes can access affordable supplemental stop-loss insurance designed specifically to manage pharmacy risk within RxPharmacy Assurance. The unique solution limits the amount that a plan or its stop-loss carrier are required to pay to safeguard against unexpected and potentially catastrophic specialty claims.

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