PA 106 Compliance Quote
SET SEG’s PA 106 compliance quote fulfills public employer requirements or pooled plan requirements for procuring medical, dental, and vision quotes from four carriers every three years – one carrier out of the four is a voluntary employees’ beneficiary association (VEBA).
- PA 106 compliant quote for medical, dental and vision benefits meeting compliance requirements for three years from
DISTRICT REQUIRED DOCUMENTS
If you are interested in SET SEG fulfilling your PA 106 compliance quote needs, the following documentation will be required for service fulfillment:
- Business associate agreement
- Authorization to quote letter
- District census
- Current renewal with rate information for medical, dental, and vision benefits
- In the event your plan is self-funded, your IR (illustrative rates) should be provided
- Minimum 12 months of claims experience
- Benefits-at-a-Glance summaries (BAAGs) or summary of benefits and coverage (SBCs) for your medical, dental, and vision plans
Note: All document templates will be provided.
FREQUENTLY ASKED QUESTIONS
Q: If our benefits are pooled plans, do I still need a PA 106?
A: Section 124.75 of the Public Employers Health Benefit Act (PA 106) states: A public employer or pooled plan procuring coverage or benefits from 1 or more carriers shall solicit from different carriers 4 or more bids every 3 years when renewing or continuing a medical benefit plan, including at least 1 bid from a voluntary employees’ beneficiary association described in section 501(c)(9) of the internal revenue code, 26 USC 501(c)(9) …
While SET SEG is not a law firm, we have approached this legislation as a floor and not a ceiling for compliance. In our practice of
the act, we have found employers with pooled benefits exercise due diligence and often look to fulfill the compliance in the spirit of the law.
Q: Why does SET SEG need all requested district documents to quote?
A: Enrollment demographics, claims experience, and requested plan designs all impact a carrier’s rate development. Supplying this information can provide a fiscal advantage to an employer, since the carrier can better predict a group’s insurable risk resulting in more competitive rates for the group. On the other hand, less information often results in more conservative, less competitive rates, or even a carrier declining to quote if the lack of information makes the insurable risk too unpredictable for the carrier.
Q: What does SET SEG do with the requested documentation for my district?
A: Enrollment demographics, claims experience, and plan designs are securely submitted to carriers with a request for proposal (RFP). SET SEG also uses this information to prepare your PA 106 compliance quote into our proposal formats.