Patent ID: 8612266
Filing Date: 2013-12-17
Classification: G06Q

Abstract:
1. A computer-implemented method comprising establishing, automatically by a computer, a health insurance plan for one or more client groups, wherein the health insurance plan comprises at least three layers of financial responsibility, wherein each client group comprises one or more plan members, and wherein the establishing further comprises: creating a first layer of financial responsibility within a total claim liability continuum of the health insurance plan, the first layer comprising a self-funded layer defining the financial responsibility of a respective client group for health insurance claims up to a first percentage level of an expected amount of a cumulative claim value in a plan period, the cumulative claim value being an estimated total value of all individual plan members claim totals expected within the plan period based on actuarial data for the respective client group, wherein each of the individual plan members claim totals is limited to a specific stop loss threshold; creating a second layer of financial responsibility within the total claim liability continuum, the second layer comprising a stop loss layer defining the financial responsibility of a stop loss insurance company for health insurance claims above a second percentage level of the expected amount, the second percentage level being higher than the first percentage level; and creating at least one intermediate layer of financial responsibility within the total claim liability continuum, the at least one intermediate layer comprising a mutually-funded layer defining the financial responsibility of an intermediate coverage insurance company for health insurance claims between the first and second percentage level.