Provider Excess

With the Affordable Care Act driving health care away from fee-for-service and toward quality- and value-based reimbursement, alternative payment models are quickly gaining prominence. Risk-based contracts or capitation, for example, place risk on the provider to incentivize value-based performance.

Summit Re offers provider excess loss (PXS) coverage designed to protect at-risk provider organizations from catastrophic losses by limiting financial responsibility to a specific dollar amount per patient for the services covered in a risk contract. A variety of deductible and coinsurance options allow us to tailor coverage depending on each client’s appetite for risk.

We offer:

  • Professional, hospital, or comprehensive coverage
  • Deductibles ranging from $10K to $1M
  • A 12/18 claims period (claims incurred within the 12-month policy period may be reported up to six months following the policy period)
  • 90% coinsurance
  • Annual limits from $500K to unlimited
  • Alternative funding options, including:
    • Aggregating specific deductible
    • Retained corridor
    • Experience refund
  • Full access to our Summit ReSources comprehensive medical management services.

Summit Re is the exclusive writer of provider excess products for Zurich American Insurance Company. To learn more about PXS options with Summit Re, contact us.