STOP LOSS INSURANCE

2026-11-03

Physician Provider and Facility Disruption Analysis . ASO rates shall be provided for all legacy , NJEHP and the GSHP options . Include a $ 200 , 000 Communication Allowance . Identify the amount of Wellness fund you intend to provide as well as describe all features of the program including nutrition support requesting $ 300 , 000 . 10 . Rate Guarantees : 3 - year period ASO . 12 months Stop Loss . Incumbent carrier Aetna will manage runout claims incurred prior to 7 / 1 / 2026 . Network Discount Analysis and Discount Guarantees . Commissions : • Stop Loss : Broker teams to split 15 % of premium but not to exceed $ 700 , 000 on an equivalent basis . • ASO : $ 7 . 38 PEPM , not to exceed $ 530 , 000 . Renewals must be provided at least 120 days in advance of July 1 , renewal date . All contracts must be guaranteed for the rate guarantee period and cannot be canceled by the carrier except for NBOE ’ s failure to pay premium . Monthly claim , premium and enrollment reporting for the entire group must be provided . Annual detailed claims utilization reports to be provided by March 1 each year . Identify how your organization will provide ID cards , claim forms , SBCs ( prior to the effective date ) and benefit summaries prepared by carrier . Booklet drafts and contracts must be received within 60 days of the effective date . No active , disabled , retiree , or COBRA enrollee or dependent will lose coverage due to a change in carriers . The actively at work requirement will be waived for current enrollees covered by the plan . Vendor must agree to indemnify and hold harmless NBOE and its employees with respect to all claims , suits , actions , liabilities , and costs of any kind arising from the administrator ’ s action or omissions and those of its agents and subcontractors under this program ...

New Jersey

2026-04-29