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The Ionic Group, a provider group with 10,000 plan members, purchased for its hospital risk pool aggregate stop-loss ins

Posted: Fri May 05, 2023 11:03 am
by answerhappygod
The Ionic Group, a provider group with 10,000 plan members, purchased for its hospital risk pool aggregate stop-loss insurance with a threshold of 110% of projected costs and a 10% coinsurance provision. Ionic funds the hospital risk pool at $40 per member per month (PMPM).
If Ionic's actual hospital costs are $5,580,000 for the year, then, under the aggregate stop-loss agreement, the stop-loss insurer is responsible for reimbursing Ionic in the amount of:

A. $30,000
B. $270,000
C. $300,000
D. $702,000