Medical Risk Managers Expands Stop-Loss Insurance to Small Businesses With Gradient AI

Greater Access to Key Claims and Underwriting Data Enables Insurer to Offer Stop Loss Solutions to Small, Self-Funded Businesses

Gradient AI, a leading enterprise software provider of artificial intelligence (AI) solutions in the insurance industry, announced that Medical Risk Managers (MRM), the largest full service Managing General Underwriter (MGU) in the nation, is using Gradient AI’s SAIL solution to offer stop loss insurance to small, self-funded groups.

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“With the increasing cost of healthcare, we are finding that self-funded plans with stop loss insurance have become very popular with smaller groups”

As healthcare costs continue to rise, more small and midsize employers are turning to self-funded insurance plans. To offset the financial risks of these plans, employers often buy high-deductible stop-loss policies to cover the risk of unexpected catastrophic claims. In the past, mostly large companies have self-insured since it has been difficult for small companies to obtain the claims data essential to purchase stop-loss insurance.

For over 35 years, Medical Risk Managers, Inc. has underwritten stop loss insurance on behalf of its insurance carrier partners. In response to increased client requests and the changing business landscape, MRM is seeking to assist more small businesses with self-funded solutions. This led MRM to develop its small business underwriting expertise and to expand its underwriting and pricing capabilities to specifically serve this market. After evaluating multiple options, MRM chose Gradient AI’s SAIL solution based on its advanced analytics capabilities as well as its breadth and depth of medical, lab, and prescription data.

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“With the increasing cost of healthcare, we are finding that self-funded plans with stop loss insurance have become very popular with smaller groups,” explained Chris Rice, president, Medical Risk Managers. “Self-funded plans offer greater flexibility, control, and cost-saving opportunities. However, until now, we were not able to offer these plans to smaller businesses due to the lack of claims history available. Now with access to robust data and analytics that Gradient AI’s SAIL solution provides, we can quote business that was simply not possible before.”

With Gradient AI’s vast dataset and machine learning capabilities, MRM can evaluate group health risk at a deeper level. Combined with its own expertise, MRM can create highly customized and cost-effective self-insured solutions, enabling employers who may have previously been unable to self-insure to now do so. By leveraging Gradient AI’s SAIL medical underwriting solution, MRM is able to obtain a complete and accurate picture of the health profile of a particular group.

“MRM’s ability to now offer stop-loss insurance to small businesses has expanded its market while enabling these businesses and their employees, and families to enjoy better, more cost-effective healthcare coverage. We are delighted to be part of the solution that makes all of this possible,” said Stan Smith, CEO and founder of Gradient AI. “As MRM continues to grow, we are committed to supporting their mission of offering stop loss coverage at any deductible level, over any network, and in any zip code nationwide.”

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