Job Summary:

The Senior Stop Loss Underwriter is responsible for evaluating, pricing, and managing risk for employer-sponsored self-funded health plans. This role includes underwriting both new business and renewals, assessing specific and aggregate exposure, and ensuring profitability while maintaining competitive positioning in the marketplace.

The Senior Stop Loss Underwriter collaborates with sales, clinical, policy, and claims teams to deliver sound underwriting decisions aligned with company guidelines and financial objectives.

Responsibilities:

• Review employer census data, claims experience, and large claimant reports
• Evaluate specific and aggregate risk exposure and establish appropriate attachment points, lasers, and aggregate corridors
• Price stop loss coverage in accordance with underwriting guidelines
• Analyze emerging large claims and assess recurrence risk
• Underwrite new employer groups seeking stop loss coverage
• Analyze renewal performance and determine rate adjustments
• Balance competitiveness with profitability targets
• Provide alternative quoting strategies when appropriate
• Communicate underwriting decisions clearly and professionally with producers
• Support producers during negotiations
• Partner with clinical underwriting on high-cost cases
• Coordinate with policy administration to ensure accurate contract terms
• Adhere to delegated underwriting authority
• Ensure compliance with state and federal regulations
• Provide guidance and mentorship to junior underwriters.
• Contribute to underwriting best practices, process improvements, and training initiatives.
• Serve as a subject matter expert on complex or high-risk cases.

Requirements:

• 5+ years of stop loss underwriting experience (specific & aggregate preferred)
• Strong knowledge of self-funded health plan structures
• Experience reviewing large claimant reports and medical diagnoses
• Proficiency in underwriting models and rating tools

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