Job Description

Senior Underwriter – Stop Loss Insurance Programs

Job Summary

Seeking a highly skilled and experienced Senior Underwriter to join a team in a hybrid work environment. The ideal candidate will be responsible for underwriting, pricing, and managing stop loss insurance programs, with a primary focus on level-funded stop-loss arrangements and traditional specific and aggregate stop-loss policies. This role offers a unique opportunity to manage and grow an established stop loss MGU and its book of business, reporting directly to the Chief Actuarial Officer. The Senior Underwriter will play a critical role in ensuring disciplined risk management, accurate policy administration, and efficient claims and financial oversight.

Compensation Package

• Salary: $130,000 - $150,000 (commensurate with experience)
• Bonus Structure: Competitive and aligned with experience
• Work Environment: Hybrid (combination of remote and in-office work)

Responsibilities

Underwriting & Pricing

• Evaluate and price level-funded stop loss programs, including specific and aggregate coverage components.
• Underwrite traditional stop loss policies across a range of employer sizes.
• Analyze census data, plan designs, claims experience, large claimant disclosures, and risk factors.
• Develop and document underwriting rationale in alignment with carrier guidelines and MGU authority.
• Present recommendations to stakeholders when required by authority thresholds.
• Manage new business quotes, renewals, and mid-year plan changes.
• Monitor block performance and adjust pricing strategies as needed.

Portfolio & Risk Management

• Assess TPA administrative models to identify adverse selection risks and favorable opportunities.
• Track loss ratios and emerging claim trends within the MGU block.
• Conduct quarterly renewal projections and profitability analyses.
• Maintain underwriting discipline in alignment with reinsurance and carrier agreements.

Policy Administration

• Oversee policy issuance, amendments, and contract documentation.
• Ensure compliance with carrier agreements and regulatory requirements.
• Maintain accurate policy and risk records within underwriting systems.

Claims Oversight

• Review and process stop loss claims in accordance with policy provisions.
• Interpret contract language to determine claim eligibility.
• Collaborate with TPA on large claim reviews and reimbursement timing.
• Monitor large claimant activity and update underwriting forecasts accordingly.
• Ensure accurate and timely reimbursement processing.

Accounting & Financial Oversight

• Reconcile premium billing and remittance reporting.
• Coordinate premium accounting with TPA.
• Support financial reporting for MGU leadership and stakeholders.

Partner Relations

• Serve as a subject matter expert for internal and external stakeholders.
• Build and maintain strong relationships with TPA and reinsurance partners.
• Support business development initiatives as appropriate.

Qualifications/Requirements

• Experience: 7+ years of stop loss underwriting experience (level-funded experience required).
• Technical Expertise: Proficiency in underwriting both specific and aggregate stop loss coverage.
• Knowledge Base: Strong understanding of self-funded medical plan structures, TPA administration, and stop loss contract provisions (e.g., 12/12, 15/12, 24/12 contracts, aggregating factors, terminal liability).
• Analytical Skills: Strong financial acumen with the ability to interpret loss ratio trends.
• Technical Proficiency: Advanced skills in Excel and underwriting analytics tools.
• Communication: Excellent written and verbal communication skills.

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