While the MUGs are used for initial underwriting, the RenewalMUGs are used for renewal underwriting risk assessment. The RenewalMUGs are based on the MUGs and assess health status using claim data, rather than information from underwriting applications. RenewalMUGs use claim, pharmacy, premium, and enrollment information to identify the conditions and relative health status of members.
With RenewalMUGs, it's easy for the underwriter to review member specific conditions and debits. RenewalMUGs is calibrated for each client to ensure that the health status load factors complement the manual rating variables, such as age/gender factors and family size categories. Utilizing three years of data, RenewalMUGs calculates each member’s months of coverage, and adjusts the member's debit score if the claim data are not complete.
RenewalMUGs is based on the MUGs and assesses health status using administrative data, rather than a questionnaire. RenewalMUGs uses all available administrative data (claims, cap, pharmacy, premium, and enrollment) to identify the conditions and relative health status of members.
The RenewalMUGs software package is designed to provide maximum flexibility and convenience. Data source files can be input in any of three formats (text, Access, or SQL). Data input structures are well defined and make it easy to map source data to standard structures. Standard reports are produced in Excel for maximum flexibility, and a series of output files can be easily accessed for detailed reporting. Web-based demonstrations are available.
Get a competitive edge
The RenewalMUGs risk adjuster is unique in the marketplace in that it was developed by clinical and financial underwriting experts specifically for use in small group medical underwriting. Extensive real-world use has demonstrated that our risk adjuster is transparent, has an intuitive design, and provides a competitive edge in small group and individual medical underwriting.
Comprehensive and proven
The Milliman MUGs were developed specifically for medical underwriting and contain rating information for approximately 1,400 conditions. The MUGs are used by approximately 130 clients and have a consistent track record of success. RenewalMUGs are based on the MUGs new business rating and identify member conditions via claim data, rather than a questionnaire.
Contact your Milliman consultant or Will Fox if you are interested in licensing this product.