Surrogate Maternity Liability Insurance Plan
The Surrogate Maternity Contractual Liability Insurance Plan indemnifies the Insured Intended Parent(s) up to the Limit(s) of Indemnity stated in the Schedule for their liability assumed under contract to pay medical expenses related to Maternity and Childbirth Delivery incurred during the Coverage Period by the person designated as their child-bearing Surrogate.
Intended Parents are insured for their Surrogates’ incurred medical expenses related to pregnancy, childbirth and post-partum after satisfaction of the understood and agreed policy deductible amount (i.e. self insured retention amount). The Universal Family Plan does not mandate the accessing of any preferred provider network; the Surrogate patient is permitted to receive medically necessary care from any coordinated physician and/or qualified medical facility. Member enrolled Intended Parents are given fully secured web-based access to enable the on-line tracking of their Surrogate's maternity medical expense claim activity and expenditure from the designated member services escrow account.
Additional Maternity Coverages, optional coverages available, each written as an endorsement to the Surrogate Maternity Contractual Liability Insurance Policy. (i.) Contractual Performance Indemnity Extension, indemnifies the Insured Intended Parent(s) for both their ‘Contractual Financial Obligation’ and ‘Ascertained Net Loss’ up to the Schedule Limit(s) of Indemnity in the event of the non-performance of a Contract as a direct result of the Death of the Surrogate named in the Schedule occurring during the Coverage Period. (ii.) Secondary Maternity, Back-Up Insurance, No Claims Bonus, indemnifies the Insured Intended Parent(s) in the event that any maternity and childbirth medical expenses for the contracted surrogacy are denied by the Surrogate’s personal primary health insurance plan.
Financial Case Management services are unique to the managed care industry and unlike most cost containment vehicles that utilize one size fits all networks; Universal Family through NES Assurance focuses specifically on the reproductive industry and establishes direct financial agreements for unrestricted access to quality healthcare. Member Intended Parents receive coordination and precertification of their Surrogate’s maternity medical services as well as the proactive negotiation and responsible administration of member selected provider medical costs. Our members have the ability to make informed choices based on performance of healthcare as well as expense.
Maternity Case Management, Private Nurse Online provides member Intended Parents and their Surrogate with complex and high risk maternity case management services. Case Management Services are provided by maternity nurse professionals to promote quality cost-effective healthy pregnancy outcomes.
Program Protocol includes:
- Discussions with the surrogate to provide health education on-going coordination and support
- System database diary of calendar medical appointments and relevant medical notes
- Triage care when necessary
- Periodic review of Surrogate’s (i.) biometrics and nutrition information; and, (ii.) protocols relative to OBGYN and Prenatal care
- Soft channeling care to NES approved providers
- Negotiating costs for home health services and ancillary healthcare services
In addition, the Maternity Case Management, Private Nurse Online Program web based platform allows maternity nurses the ability to document cases in real time for our payers and to upload treatment notes and billing on the same database used to manage costs. The end result: complete transparency of communication throughout the pregnancy, and a concerted effort to contain costs and provide increased customer satisfaction and security throughout the pregnancy.
|Coverages||Limits (per Surrogate)|
|Maternity Medical Expenses, Policy Limit:||$500,000 (any one pregnancy and in the aggregate)|
|In-Patient Bed Rest (sub-limit):||$50,000 (any one pregnancy, pre-authorization required)|
|Contractual Performance Indemnity Extension:||$250,000 (Contractual Financial Obligation, Surrogate Named Beneficiary) |
$100,000 (Ascertained Net Loss, IP Limit Amount )
|PROVISIONAL SELF INSURED RETENTION:||AMOUNTS|
|Single Birth:||$15,000 to $45,000 (any one Surrogate, any one pregnancy)|
|Twin Birth:||$30,000 to $60,000 (any one Surrogate, any one pregnancy)|
|Plan Period:||Up to 18 Months|
|Premium:||From $4,200 to $10,350, plus taxes and fees, if applicable (any one Surrogate, any one pregnancy)|
Optional Coverages Available:
i. Contractual Performance Indemnity (Death of Surrogate):
Additional Premium $575, plus taxes and fees, if applicable (any one Surrogate, any one pregnancy)
|ii. Secondary Back-Up Maternity:||No Claims Bonus, 80.0% Return Premium Less a $250 Administrative Fee|
Case Management, Enrollment Fees:
Financial Case Management:
$1,250 (any one Surrogate)
|Maternity Case Management:||Based on Member Level of Service Selected, fee for enrollment to be deducted from the aggregate Self-Insured Retention [the amount] for medically confirmed Twin Pregnancies Only.|
|Insurer:||(A.M. Best’s “A” Rated, Excellent)|