Selected Reinsurance Data from Wisconsin HMO Filings

Table C-2 Selected Reinsurance Data from Wisconsin HMO Filings, Sorted by Premiums

No.	Company	Reinsurance Expense Net Recoveries	Total Premiums Earned	Name of Reinsurer	Limits of Coverage	Exp Date	Comments
1	The Primecare Health Plan, Inc.	994,846	294,304,509	United Health & LIfe Insurance Co.	$100,000 stop loss commercial & medicaid, $35,000 stop loss medicare risk (both with certain limitations)	12/31/96
2	Compcare Health Services Insurance Corporation	(1,409,619)	276,005,290	(1) United Wisconsin Insurance Company	POS claims in excess of 95% of premium. No exp. date (90 days prior written notice).
				(2) American Accident Reinsurance Group	Transplant claims for heart, heart/lung, lung, liver, pancreas, pancreas/kidney, and bone marrow, exceeding $200,000 up to $1,000,000. Exp 12/31/95
3	The Dean Health Plan, Inc.	(198,419)	239,733,824	John Alden Life Insurance	$150,000	12/31/95
4	The Family Health Plan Cooperative	108,827	176,465,229	Allianz	$115,000, maximum lifetime of $2 million	01/31/97
5	Humana Wisconsin Health Organization Insurance Corportation	58,294	160,367,923	Allianz Life Insurance Co. of North America	$2 million per member lifetime maximum	All policies are continuous
6	The Physicians Plus Insurance Corporation	299,662	128,327,143	Northwestern National Life Insurance Co.	Inpatient charges in excess of $125,000 per member per calendar year.	12/31/95
7	Security Health Plan of Wisconsin	51,273	113,081,076	N/A	N/A	N/A	"Marshfield Clinic is guarantor of Security Health Plan of Wisconsin, Inc."
8	Unity Health Plans Insurance Corp.	(418,736)	100,356,383	Northern National Life	$1 million annual limit per member, $2 million lifetime per member	01/01/96
9	United Health of Wisconsin	463,569	76,086,561	John Alden Life Insurance Company	$100,000 deductible, 90% coinsurance over deductible	09/30/96
10	The North Central Health Protection Plan (A Cooperative Plan)	1,894,158	61,662,259	Employers Insurance of Wausau A Mutual Company	$200,000 individual, $750,000 aggregate	01/01/97
11	Network Health Plan of Wisconsin, Inc.	(619,923)	60,194,222	Lincoln National Insurance	Varies by facility and procedure in excess of $55,000 per member per year.	12/31/95
12	The Group Health Cooperative of South Central Wisconsin	181,600	58,113,771	Allianz Life Insurance Co. of North America	$80,000 ded. in 1995, $85,000 ded. in 1996 for hospital services.	(1/1/95 renewal)
					Eligible hosp svcs: 90% if performed "per diem," 80% if performed in any other hospital. Organ and bone marrow transplant: 80% if performed w/ Prior Approved Transplant Reimb Schedule, 50% if performed in other hospital, or retransplantation
13	EMPHESYS Wisconsin Insurance Company	170,296	42,952,911	Employers Health Insurance Company	"Various"	"Various"
14	Valley Health Plan	(434,985)	41,868,909	United Wisconsin Inurance Company	$60,000 annual deductible per member, 50-90% coverage for hospital expenses excess loss	12/31/95
15	Managed Health Services Insurance Group	(118,427)	40,020,500	Lincoln National Health and Casualty Insurance Co.	$2 million per individual	11/30/96
16	Maxicare Health Insurance Co.	0	27,131,914	"HMO is self-insured for this coverage"
17	Group Health Cooperative of Eau Claire	112,873	21,444,222	Allianz Life Insurance Co. of North America	$79,000 deductible, $2 million each member	Renewed 1/1/96 to 12/31/97
18	The Greater LaCrosse Health Plans, Inc.	(265,707)	17,660,753	Employers Insurance of Wausau, A Mutual Company	$100,000 ded per individual per year	Continuous
19	Atrium Health Plan, Inc.	675,338	14,944,419	BCBSB D/B/A Blue Cross and Blue Shield of Minnesota	$1 million per member per calendar year, $50,000 deductible	12/31/96
20	The MercyCare Health Plan, Inc.	85,312	11,873,528	John Alden Insurance Company	Inpatient: Ded: $35K; Coins: MCHP pays 10% of amts over $35K; Max=$1M; Per diem at all facilities except Mercy = $2,500. Physician: Ded=$15K, Coins: MCHP pays 20% of amt over $15K; Max=$1M	12/31/95
21	Medical Associates Clinic Health Plan of Wisconsin	173,175	7,492,327	Lincoln National Reinsurance Co.	$85,000 ded, $2 million life time	12/31/96
	Family Health Network, Inc.	3,657	190,461
	Genesis	244,526	8,240,050
	Gundersen	24,155	3,142,616
	MetraHealth Care Plan of WI	(20,104)	454,652

Source: The Lewin Group tabulations of HMO Annual Statement data Wisconsin.