Specific coverage
Reimburses the MRHIF member (local HIF) for claims from any one person per contract year that exceeds its self insured retention “SIR”
Aggregate coverage Reimburses the MRHIF member (local HIF) for eligible claims for the entire group that exceed a predetermined amount, typically 120% of expected claims.
Aggregating Specific coverage This coverage caps the MRHIF’s exposure for the portion risk it shares reinsuring its members for specific claims. The MRHIF typically budgets at or close to where the reinsurer caps the claims.
The Municipal Reinsurance Health Insurance Fund or the MRHIF is a Joint Insurance Fund formed pursuant to NJSA 40A:10-36 et-Seq. The MRHIF was established in 1999 when its four original member regional Health Insurance Funds “HIF”s determined that additional cost savings could be achieved by pooling together to provide excess reinsurance and jointly purchasing on other health related services.
The MRHIF provides both Specific and Aggregate reinsurance coverage above its member “HIF”s Self Insured Retentions “SIR” for Medical and Prescription Drugs. The Fund has also procured TPA services, provider networks, Prescription Benefit Manager, wellness programs, enrollments systems and other related services on a joint purchase bases.
In addition to its HIF members the MRHIF will consider membership for self-insured local units that have at least 750 covered lives such as larger municipalities, Board of Educations, Counties etc.
As of 2023 the Fund includes Six regional local member HIFs, that insure over 290 Municipalities and/or School Districts in New Jersey.
Reimburses
the
MRHIF
member
(local
HIF)
for
claims
from
any
one
person
per
contract
year
that
exceeds
its
self
insured
retention
“SIR”
Aggregate coverage- Available
Reimburses the MRHIF member (local HIF) for eligible claims for the entire group that exceed a predetermined amount, typically 120% of expected claims.
Specific/Individual Reinsurance Coverage:
Specific/Individual Stop Loss:
A shock loss may be defined as an abnormally large and unexpected claim
Could be the result of severe accident or serious illness
Each local HIF is protected against the financial impact shock losses can cause over their selected Self Insured Retention “SIR” .
Dave Vozza is ready to work with you and help you navigate the program.