planning for trp

Protecting ACO’s Downside Risk With Aggregate Reinsurance

Managing the overall financial impact of risk based contracts is vital for providers to ensure the long-term financial success of their organizations as a whole.

Insurance plays a key role in protecting against the downside financial impact of risk-based contracts and two types of insurance in particular can play a role:

  • Specific stop-loss insurance that protects the provider from the financial risk associated with high dollar claims for individual members in their risk population.
  • Aggregate stop-loss insurance that protects the provider from the overall performance of a given risk-based contract.

Today’s risk-based provider contracts often remove or limit the risk associated with high dollar claims within a population so many providers do not need a specific stop-loss policy. They still have concerns about the financial risk associated with these contracts though and many are seeking some level of aggregate stop-loss.

In the commercial insurance market, there is a limited capacity for aggregate provider stop-loss policies with only a handful of insurers and maximum aggregate limits of $10 million to $15 million.

Because of the shortage of commercially available aggregate provider stop-loss insurance, Re-Solutions and Dubraski & Associates are pleased to announce the development of an ACO AGGREGATE INSURANCE FACILITY that broadens the options in this space. The facility will:

  • Offer aggregate limits up to $50 million
  • Issue policies on A-rated paper
  • Be ideal for organizations who have a large number of attributed lives and therefore need a sizeable aggregate limit

We are confident that we have a risk solution that will meet your needs.  To discuss the insurance options available to protect your organization’s specific and/or aggregate downside risk, please contact Chuck Newton at or  804.647.8360.

Post Comment

Your email address will not be published. Required fields are marked *