It is not good. This analogy demonstrates why:
Accepting the CMS offer is like buying fire insurance for your home, without knowing the price. Then, when your house burns down, you find out the price of the insurance, which is then deducted from the loss. Secondly, you discover that your risk is not totally covered, because your payout is based on a percentage (or a variable coinsurance) of each item you lost. Lastly, you will not receive your payout for 6 to 8 months after the loss occurred.
You would never insure your home like this.
So why would you accept this deal for your DCE?
We are experts in stop loss and reinsurance for managed care risks.
We provide better pricing, based on a more comprehensive review of your risk (not a canned approach).
Structure your policy on an Aggregate and Specific basis, so that every eligible high-dollar case can be covered on every patient, not just some.
If you choose Specific coverage and there is a loss, you will get your claims paid within 30 to 45 days (rather than 6 to 8 months) after your cohort year is over.