This document provides instructions for entering claims data from a previous year's self-funded health plan into a quote tool. It asks for information like the effective date and length of the previous plan, average monthly enrollment, deductibles, coinsurance, and out-of-pocket maximums. It also requests total claims amounts by month and for any members who exceeded a large claims threshold, and whether the claims reports include just paid or both paid and incurred claims. Once all the information is entered, clicking "Finished" will save the entries.

1. How to Enter Claims Data Into Your Quote

2. What was the
effective date
of the previous
year’s plan?

3. How long was the previous
year’s contract?
(Typically 12 months)

4. What was the average
monthly enrolled
employees in this plan year?

5. What was the assumed
discount on this plan?
(Can often be found on
monthly premium vs
claims reports)

6. What kind of plan was it?
A traditional plan with copays
or an HSA eligible plan?

7. What was the average
deductible across all plans
during this time period?

8. What was the average
coinsurance across all plans
during this time period?

9. What was the average out-of-
pocket max across all plans
offered during this time period?

10. Select the Rx plan
that most closely
resembles the plan
offered during this
time period.

11. What is the most recent
date for which paid
claims are included in
the experience?

12. Select whether
claims reports
include only paid
claims or paid and
incurred claims.

13. Enter the total claims
for each member
who exceeded the
large claims
threshold.
Use the “+” to add
each additional large
claim.

14. What were the
total claims per
month?

15. Click “Finished” to save your entries.
Add another year of claims

16. Visit allay.io to request access to use Allay to
model and quote self-funded health plans