StepWise® Medical Underwriter Overview

Set appropriate rates

Each new underwriting case presents both opportunity and risk. Set your rate too high and lose the group, set it too low and lose revenue. You need tools that help you set the appropriate rate for each case. StepWise Medical Underwriter delivers consistent and accurate individual and small group underwriting information to help you make sound decisions

StepWise Medical Underwriter helps you:

• Determine the medical underwriting premium load to apply to each employer group based on the medical history of its members
• Identify prospective members with pre-existing medical conditions
• Maximize consistency between prospect and renewal business

Flexible modeling tool

StepWise Medical Underwriter performs quick and accurate health insurance medical underwriting rate adjustments based on applicants’ reported medical conditions. With its easy-to-use, point-and-click features, you can enter over 500 conditions with more than 2,000 specifications of the conditions and then quantify the financial effect of those different conditions. You can also generate a premium load given the number of debits and the size of the group, override the application at the condition or group level, and track incomplete information for later follow-up.

Current, applicable data

This solution captures prescription information, links it to conditions, and incorporates input from clinicians, medical underwriters, and small group marketers. OptumInsight updates the underlying StepWise Medical Underwriter tables for changes in health care costs and utilizations using proprietary data from one of the largest databases of managed care experience in the country.