March 2018

Intermediary Insurance Services, Inc. (iiSi) Endorses RxResults

 

We have seen a spike in the cost of specialty drugs, which represent 1% of the all prescription drugs dispensed, however they account for 35%+ of all drug costs.  It is anticipated that specialty drug costs will reach 50% of all drug expenditures.    In an effort to stem the high cost of specialty drug use, iiSi has endorsed a pre-certification program provided by RxResults.

 

RxResults is an evidence-based pharmacy risk management company that provides an independent pre-authorization service for specialty drug dispensing.  RxResults finds that through their pre-certification process that 68% of the prescriptions are approved, 12% are withdrawn and 20% are denied.  This process eliminates 30%+ of the specialty drug prescriptions. One of their notable observations is only 36% of the hep C prescriptions are approved being many are denied as not meeting the drug’s clinical criteria.  RxResults is seeing savings anywhere from 12% to 45% with their Specialty Drug Management program.

 

The benefits of this program are:

  • Controls the utilization of specialty drugs                    
  • Eliminates the conflict of interest with PBMs providing their own prior-authorization, which is advantageous to the PBM’s bottom-line along with the distributor receiving incentives and rebates                                          
  • Reduces Plan costs by recommending lower cost alternatives                                  
  • Detailed drug analytics leading to evidenced-base determination of prescribed specialty drugs                     
  • Reduces the frequency of lasers and increases in aggregate attachment point factors

 

This is a first step in helping to address rising specialty drug expenses. For more information contact L.G. Hanzel, Principal & VP of RxResults at (817) 296-8147 or visit the RxResults’ website at www.rxresults.com.


 September 2015

New ICD-10 Trigger Diagnosis Listing

iiSi has revised our claim disclosure form to reference the new ICD-10 clinical cataloging system that goes in effect October 1, 2015. The new ICD-10 diagnosis listing has been expanded to reference the more detailed coding classifications and replaces the previous ICD-9 code listing. The new attached claim disclosure form should be used for future submission. During the transition period, both previous (ICD-9) and new (ICD-10) claim disclosure forms will be accepted. Contact your underwriter or marketing representative should you have any questions.

New ICD-10 Claim Disclosure Form (187Kb PDF)


 February 2013

Intermediary Insurance Services, Inc. (iiSi)
Celebrates 30 Years as Medical Stop Loss Underwriting Organization

iiSi, headquartered in San Francisco, CA, announced that it is celebrating its 30th year as a medical stop loss underwriting organization. Founded in 1983, iiSi has become one of the leading stop loss underwriters in the country by providing effective risk management solutions and comprehensive managed care resources to the self-funded community. As a full-service organization, iiSi has worked closely with its carriers, producers, third party administrators and policy holders to provide products that meet the needs of the self-funded marketplace.

"We are very proud of our heritage of being one of the longest standing medical stop loss managers in the U.S. today", said Christopher Hutton, President. "We can attribute our success to the professionalism and enthusiasm of our employees, and the loyalty and support of our business partners and clients. We are very appreciative of everyone that has helped make this possible and contributed to our success. We look forward to many more successful and enjoyable years, confident that the experience and expertise gained over the last 30 years will enable us to meet the challenges and uncertainties that the future will undoubtedly bring".


January 2013

New Addition to the iiSi Underwriting Team

We are please to announce the addition of Matt Robinson to our staff. Matt comes to us with 14 years of employer medical stop loss experience having worked in both the carrier and MGU environments. That together with a degree in actuarial sciences makes him a uniquely qualified addition to our highly professional underwriting team.

Matt will be working from a satellite office located Kingston Springs, TN.

 


February 2012

***** NEW IRO EXTENSION AMENDMENT *****

iiSi is pleased to announce that all of our stop loss carriers have confirmed that they will extend coverage for Independent Review Organization (IRO) decisions pertaining to previously denied medical claims. This policy enhancement provides protection for an employer who is required under the new Patient Protection and Affordable Care Act (PPACA) to cover IRO decisions on overturned denials of previously processed claims.

This extended coverage is applicable for groups written or renewing on or after January 1, 2012. This coverage is provided without any additional premium surcharge. The “denied” date of the initial claim will be considered the “paid” date for policy tracking purposes. Complete details are stated in the actual policy amendment.

We are pleased that our carriers have added this coverage to their policies as a means to alleviate potential gaps in employer self-funded medical plans.

Please contact your iiSi Marketing Representative should you need more details.

 



October 2011

New Global Emergency Services Program

 

Intermediary Insurance Services, Inc. is pleased to announce that effective October 1, 2011, all of its Companion Life Stop Loss clients now have access to global emergency services through Assist America.  Assist America s vast array of resources covers individuals whenever they travel 100 miles or more from home or while in another country.  This value added benefit will be included in all Companion Life stop loss contracts at no additional cost to clients. 

 

The global emergency services include:

  • Medical Consultation & Referral                 Ÿ    Legal & Interpreter Referrals
  • Medical Monitoring                                       Ÿ    Emergency Trauma Counseling
  • Prescription Assistance                               Ÿ    Return of Mortal Remains
  • Hospital Admission Assistance                  Ÿ    Medical Repatriation
  • Emergency Medical Evacuation                 Ÿ    Care of Minor Children
  • Compassionate Visit

 

Assist America pays for all of the assistance services it provides with no caps, limits or charge-backs to anyone, and with no exclusions for pre-existing conditions, adventure sports, geographic risk or alcohol-related incidents.

 

For more information or to see a brochure click on the Assist America tab on the iiSi website www.iisinet.com .  You can also contact your iiSi Marketing Representative.