The selected vendor will be expected to provide the following services. • Timely issue all enrolled and approved stop loss policies to the County. • Timely notify the County of any amendments or changes to the policy which must be mutually agreed upon between respondent and the County within one week. • Maintain a stop loss claims database for all submitted stop loss claims using information provided by the County or acquired from its designated representatives, e.g., Blue KC and MedOne. • Acquire and process stop loss reimbursement claims from Blue KC and possibly MedOne. MedOne provides a monthly high-cost claimant report. Blue KC requires the stop loss carrier to download claim information from its claims portal site; both claimants who have attained 50% of the stop loss deductible and claimants who have exceeded the specific stop loss deductible. • Timely request (within one week) any additional information needed by respondent to determine, and document claim submission enabling issuance of reimbursement to the County.
