https://completemarkets.com/company/apexdatasystems/Re-Insurance/
Whether for small groups or large groups, self-insurance is often a reasonable alternative to a fully-insured employee benefit program. To be successful, plan administrators need an efficient, easy-to-use system, providing timely plan data and quantitative analyses to make quality decisions. The state-of-the-art software solutions from Apex Data Systems deliver this level of quality and support to Third Party Administrators, Associations, Self-Administering Employers, and other entities challenged with handling the full administration and claims responsibilities of a self-funded trust.
No matter how small the organization, to have a strong plan requires a strong system that offers flexibility, accuracy, and full functionality. While also available modularly, the complete systems from Apex Data Systems encompass both administration and claims features delivering a total solution for both professional plan administrators and self-administered groups.
Administration Capabilities
Apex Data Systems' approach to administration of self-funded programs is not a "watered-down" version, but rather a complete software solution. It includes all the features, if needed, to handle the details of plan design, underwriting, rating, enrollment, billing, cash receipts, posting, delinquency tracking, agent commission processing, renewals, financial reporting, and more. Functionality of special interest to self-funded plan administrators and self-administered groups includes:
Ability to support multiple plans and cafeteria selection of benefits at the employee and dependent level.
Ability to define contributory and non-contributory programs.
User-definable plans carrying unique data fields regarding funding vehicle, reinsurance carrier, policy number, plan year period, certificate issue flags, and other elements that allow these records to define self-insured, reinsured, and fully-insured products.
Ability to self-fund by product type or plan code while other coverages are fully-insured, and to have any number of insurance carriers underwrite different contracts, to support the various products offered under an employee benefit program.
Consolidated billing on a single invoice for health or other self-funded contributions, specific and aggregate premiums, and life insurance or other fully-insured plan premiums.
Administration fee billing combined with or separate from contributions toward a claim fund.
Summary Plan Descriptions with ID cards carrying data critical to benefit verification.
Census data, enrollment information, and the ability for user defined data mining via ad-hoc query.
Analysis reporting of contributions, premiums, financial figures and data for 5500's.
Claims Capabilities
Available as a part of the consolidated system, or as a standalone module with full eligibility maintenance, the Apex Data Systems claims adjudication system documents claims activities, protects against excessive claims payments, and supports faster and more accurate claims services designed to meet the users' needs. Highlighted features include:
Capture of underlying and overlaying plans of benefits for liability of trust versus re-insurer.
Monthly reports to manage the plan by line of coverage and employee utilization.
Plan design flexibility to match previously insured benefits or suit the user's unique needs.
Claims lag reports which detail the time between treatment, the dates claim materials were first received and last received, and the date the claim was paid.
User defined maximum number of services, maximum benefits, daily allowances, co-pays, coinsurance levels, deductibles and other parameters by type of service or benefit code.
Provisions for preferred and exclusive provider organizations.
User-defined cause codes (three-digit alphanumeric field) that let you classify claims activity in a meaningful way, and report on all your claims experience.
Complete pending and correspondence support.
Seamless, real-time integration with our administration system so the current eligibility status of each insured is recognized immediately as changes are made.
Capture of claims information regarding specific and aggregate stop-loss provisions.
Automatic alerts when the claim reaches user defined reinsurance reporting point and the actual reinsurance attachment point.
Claim check issuance with provider batch payment feature and check reconciliation.
Worksheet history for submission to reinsurance carriers.
Full claims analysis reports including incurred and paid claims, lag studies, reinsurance reporting, and catastrophic losses by incurred, incurred and paid and paid dates.
Standard and ad-hoc reporting is available to support cash flow analysis and monitor reserves.
https://completemarkets.com/company/citadelinsuranceservices/program-development-and-management/
Program overview — Citadel Insurance Services: Insurance Program Development and Management
With more than 20 years of focused program development and management experience, Citadel Insurance Services provides wholesale underwriting and program administration support to independent agents and brokers. We work with start-up and established programs — designing market placement strategies, structuring coverages, and improving distribution to sustain growth. Citadel specializes in creative solutions for unique or hard-to-place programs, including book aggregation, affinity arrangements, and risk purchasing groups.
Our focus
Associations
Affinity groups
Book aggregation
Reinsurance access and program layering
Risk purchasing groups (RPGs)
Industries and classes we commonly support
Citadel has driven program success across a wide range of classes. Typical sectors include:
Real estate and property managers
Contracting and construction-related trades
Entertainment and motorsports
Healthcare and life sciences
Sport, fitness and recreation
Manufacturing and transportation (including trucking)
Professional liability / E&O for specialized occupations
Coverage highlights and advantages
This program is designed to help you place accounts that require program-level thinking rather than single-risk placement. Key strengths include:
Program design and underwriting structures tailored to affinity and association-based business.
Ability to assemble layered capacity, including reinsurance relationships to support larger or aggregated books.
Flexibility to create binding authority, master policies, or papering structures that support book aggregation and delegated distribution.
Expertise in market placement for unique or non-standard risks that need creative underwriting solutions.
Underwriting notes and submission guidance
Appetite is program-specific but generally favors group-based or program-style placements where underwriting guidelines, membership/enrollment controls, and loss control protocols can be applied. Typical items underwriters will request include:
Program summary and business model (enrollment, premium flow, eligibility rules)
Recent loss information or loss runs where available
Copies of any membership or contractual agreements tied to the program
Fee schedules, aggregation thresholds, and reinsurance structures if already in place
Minimum premiums and attachment points vary by product and carrier; specific thresholds are established on a program-by-program basis.
Territories and admitted status
This program is available in the following jurisdictions: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, DC, WV, WI, WY. Citadel currently positions these program solutions through non-admitted / surplus lines placements where appropriate and permitted; admitted options may be available with specific carriers on a case-by-case basis.
Why place program business through Citadel
Deep program-development experience — from concept to mature distribution.
Proven ability to place specialized and aggregated books with creative market solutions.
Wholesale-broker model that supports delegated authority, tailored wording, and layered capacity.
Practical underwriting guidance that helps you structure a program to attract carrier appetite while protecting risk quality.
Example client scenarios
You represent a regional association seeking to offer a branded liability program to members. Citadel can help structure eligibility rules, partner with carriers for capacity, and design enrollment and premium collection mechanics.
You have several small contractors with similar exposure that would produce a more attractive submission if aggregated. Citadel can advise on book-aggregation strategies and place combined coverage with appropriate underwriting controls.
Frequently Asked Questions
What types of accounts are a good fit for Citadel’s program development services?The best fits are group- or program-style opportunities: associations, affinity groups, book-aggregation arrangements, risk purchasing groups, and other situations where unified underwriting rules, membership controls, or pooled premium flow make a program more marketable.
Is this offered on an admitted basis?Citadel generally positions these solutions through non-admitted / surplus lines placements. Admitted options may be possible with specific carriers on a program-by-program basis; discuss the target state and product to determine availability.
What do carriers typically require on submissions?Underwriters will expect a clear program summary, eligibility and enrollment procedures, loss history if available, and any existing reinsurance or aggregation terms. The more detail you provide about controls and premium flow, the quicker carriers can assess capacity and terms.
Which states do you support?The program is available in: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, DC, WV, WI, WY. State-specific placement rules apply.
Need help placing an account? Connect with a market specialist.