Stop-loss reporting is now available through BlueInsights, Blue Cross & Blue Shield of Rhode Island’s (BCBSRI) data analytics and reporting platform. Launched in late October, this new module provides critical insights into the claims and enrollment for each of the stop-loss contracts BCBSRI administers on behalf of our Large Group ASC clients.

With the new module, brokers and clients can track individual stop-loss claims and loss ratios. For clients with aggregate insurance, the module will also track how their company is running toward the annual attachment point. By tracking stop-loss claims month over month, brokers and clients can see high-cost claimants’ top diagnoses as well as a breakdown of claims paid by member relationship. Thresholds may be customized to enable greater visibility into emerging risk within a particular group. Plus, the terms of each stop-loss contract are automatically built into the module—which helps to ensure that the claims are being tracked correctly to the particular stop-loss policy year and include run-in and/or run-out claims (based on the contract type).

The new BlueInsights module provides three years of claim history for each client and will be updated with any year-over-year contract changes—contract terms or increases in individual stop-loss levels, for example—as necessary.

Here’s how to access the new stop-loss reporting module:

• Upon logging in to BlueInsights, look for a new menu option at the top called Stop Loss.
• This option will include two sub-menu options: Presentation Reports and Ad-Hoc Analysis.
• Under Presentation Reports, you will find two print-ready reports available: Stop Loss Member Summary and Stop Loss Executive Summary.
• Under the Ad-Hoc Analysis, you will find three interactive reports available: Specific Stop Loss, Aggregate Stop Loss, and Aggregate Stop Loss by Coverage Tier.

If you have any questions, need your BlueInsights password reset, or need your BlueInsights username re-activated, please contact a member of your BCBSRI account team for assistance.