This area of the site contains our Business Partner's guide. It has all the necessary information to make our relationship successful and mutually beneficial. The guide is available in three ways:

1. HTML format - read the guide on these pages.
2. Download the full guide in portable document (pdf) format to save to your computer or print.
3. Download individual sections of interest in portable document (pdf) format to save to your computer or print.

download entire guide (pdf)

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Table of Contents
This is a collapsible list. Click topic to expand.

1. Underwriting Guide
   1. entire section (pdf)
   2. Introduction
      1. Historical Perspective
      2. Reinsurance
      3. Mission
      4. Philosophy
      5. Process Overview
   3. Product Overview
      1. Product Highlights
      2. Specific Coverage
      3. Aggregate Coverage
      4. Optional Coverage
      5. Value Added Services
   4. Industry Classifications
   5. Request For Proposal
   6. Specific Coverage Description
      1. Contract Options
      2. Specific Advance Reimbursement
      3. Specific Terminal Liability
      4. Split-Funded Products (description/definitions/examples)
   7. Aggregate Coverage Description
      1. Contract Options
      2. Aggregate Accommodation Option
      3. Aggregate Terminal Liability
   8. Medical Conversion Option
       
2. Risk Management Guide
   1. entire section (pdf)
   2. SLG Risk Management Philosophy
   3. The SLG Risk Management Process
   4. Specialty Risk Management Vendors
       
3. Administration Guide
   1. entire section (pdf)
   2. General Policy Administration
      1. Application
      2. Schedule of Insurance
      3. Disclosure Statement
      4. Premium and Enrollment Statement
      5. Master Plan Document
   3. Final Underwriting Requirements
   4. Other Important Documentation
      1. Licensing Requirements
      2. Appointment Information Sheet
      3. Producer & Compensation Agreement
      4. IRS Form W-9
   5. Issuing the Excess Loss Insurance Policy
   6. Premium Accounting
      1. Premium Payments
      2. Late Premium
      3. Premium Variance
      4. Enrollment Standards
   7. Reinstatement
   8. Rescinded or Voided Coverage
   9. Commissions
   10. Medical Conversion
   11. Revising or Amending the Master Plan Document
   12. Change in Enrollment
        
4. Claims Guide
   1. entire section (pdf)
   2. Introduction
   3. Important Contract Definitions
   4. Contract Terms
   5. Specific Claim Guide
      1. Notification Requirements
      2. Specific Claim Filing Process
         1. Filing an Initial Specific Claim
            1. Process
            2. Traditional Claim Submission
            3. Rapid Fire Claim Submission
         2. Filing a Supplemental Claim
         3. Filing a Specific Advance Reimbursement Request
      3. Special Note
      4. Specific Terminal Liability
   6. Aggregate Claim Guide
      1. TPA Monthly Reporting Requirements
      2. Aggregate Accommodation Option
      3. Aggregate Terminal Liability Option
   7. General Claim Handling Information
      1. Dental, Vision, Weekly Income and Prescription Drug Card Expense
      2. Claim Settlement and Cost Containment Expenses
         1. PPO/Repricing Fees
         2. Large Case Management (LCM) Fees
         3. Drug Card Administration Fees
         4. State Surcharges
      3. Legal Matters/Complaints
      4. Hospital Audits
      5. Split-Funded
      6. Overpayment and Claims Refunds
   8. Important Plan Document Provisions
      1. Eligibility Review
      2. Leave of Active Service
      3. Third Party Liability and Subrogation Procedures
      4. Preparing Claim Documentation
      5. Identifying Potential Third Party Liability Claims
      6. Medical Records
          
5. Forms
   1. Potentially Catastrophic Loss List
   2. Disclosure Instructions and Form
   3. Specific Advance Reimbursement
   4. Specific Split-Funded Agreement
   5. Specific Claim Form A
   6. Specific Claim Form B
   7. Liability Questionnaire
   8. Subrogation and Right of Recovery Reimbursement Agreement
   9. Higher Education Benefit Verification
   10. Plan Eligibility/Work Status
   11. Aggregate Summary Report
   12. Year End Aggregate Claim
   13. Aggregate Accommodation
   14. Aggregate Accommodation Endorsement
   15. Terminal Liability Endorsement
   16. Premium and Enrollment Statement
   17. Confidentiality Agreement
   18. Attending Physician Statement
   19. TPA Re-pricing Referral
   20. Transplant Referral
   21. Reinstatement Application
   22. Individual Medical Questionnaire
   23. Acquisition Form

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