THE PRIZM PLATFORM
Underwrite with current network discount factors you can defend
Co-developed with
Leverage a combination of market-leading actuarial adjustments and healthcare price transparency data to help ensure network discount accuracy and boost underwriting precision.
IMPACT
Enhance Network Analysis
Determine the appropriate provider network discount assumptions when pricing aggregate and specific stop-loss insurance coverage for self-funded employer groups.
Make comparisons across carrier networks and regions, modeling the impact on discounts across varying claim sizes and mix of services.
View up-to-date discount factors for all regional and national health insurance carriers.
View discounts presented from first dollar and above and below a comprehensive set of specific deductibles.
For Stop-Loss Carriers & MGUs
Why Impact for Stop-Loss Carriers & MGUs?
Set provider network discount assumptions using current contracted rates, with actuarial modeling co-developed with Windsor Strategy Partners (FSA/MAAA).
- Up-to-date discount factors across regional and national carrier networks, delivered via extract, API or through UI.
- Support Benchmark 50% reports — when a claimant reaches 50% of the specific deductible, assess whether the claim's pricing is an outlier against current market rates to sharpen reserves and flag repricing opportunities.
- Rate Manual integration via Excel extract or API, with Medical and Med+Rx outputs.
- Discounts above and below specific deductibles — from first dollar through a comprehensive set of thresholds.
Explore more of PRIZM
One platform, five ways to put price transparency data to work.
