Georgia ADS

Georgia ADS, LLC

Georgia ADS offers a mechanism to reimburse participating members for high cost claimants covered under their self-funded health benefits plans and now is the most member penetrated company in Phoenix Health Care Management Services, Inc. serving 15 of 17 stockholders.

Founded in 1991 by four VHA Georgia (Vizient MidSouth) members, this program was developed through the use of insurance consulting services, claim loss forecasting and actuarial services. The program objectives include optimizing resources by promoting and leveraging economies of scale, minimizing the risk of health claim liability and maximizing the value of the insurance dollar spent.


While the specific attachment points have changed over the years, the program currently consists of three components:

 

  • Reinsurance

$650,000  

  • Shared Financing Layer

Percent of total claims paid by
each participant

  • Self–Insured 

$225,000

 

1. Self-Insured Deductible

Participants self-insure their own claims up to $225,000.

2. Shared Financing Layer

Participants fund or finance each other’s claims between $225,000 and $650,000. Each participant is assigned an actuarially determined percent as their share of the total claims for the group. Percentages are recalculated annually and move up or down based on utilization of the program. Cumulative statements designate whether a participant is a lender or borrower to the program.

3. Reinsurance

After $650,000, participants group purchase reinsurance at a much lower rate than they would pay individually due to their combined number of lives. Including the previous layers, claims have unlimited coverage throughout each plan year.


Program advantages include:


  • Actual reflection of experience of a defined and homogenous group in participant’s loss financing
  • Improved cash flow management through claims payments only if they occur
  • Improved cash retention for investment income
  • Reduced cost of reinsurance through risk sharing, retention and economies of scale

Since the program’s inception, members have participated together in financing nearly $225 million of claims and have saved more than $100 million in premium costs.


For more information on Georgia ADS, contact Robert Taylor at 770-850-7441.

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