Group representative

Salaried employee of the insurance company who assists insurance agents and brokers in acquiring, soliciting, and negotiating with potential buyers for group insurance and to service group contracts. The representative also renegotiates renewal policies.

Group Risk

The rating cell or risk segment into which particular policies are categorized, with a type of insurance cover. The objective is to achieve a group of policies or risks that have homogeneous characteristics

Group sponsor

Individual or professional association that acts as an agent for the group and its members. It pays the dues and service charges to a health insurance plan and agrees to receive the plan’s certificate and information.

Group underwriting

May occur where a parent company controls other insurance companies within its group. Group underwriting is an alternative to interchange of business within the group. Each acceptance of business is reported to a central control where a group retention is observed in accordance with a scale of group limits reflecting the group’s commitments. Reinsurance may be arranged by the subsidiary or the parent. Centralised underwriting enables the group to maximise its underwriting capacity.
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The centralization of underwriting within a group of insurance companies, thus maximizing the group’s underwriting capacity.

group universal life (GUL) insurance

Type of group life insurance policy that has flexible premiums, adjustable protection, not fixed, and it has investment earnings that allows for some tax benefits. The death benefit is established by the amount of the premium. In this type of policy, the insured can vary the premium and death benefit amounts during the life of the policy. A group member that leaves the group can continue coverage under the group plan. Also called group universal life program (GULP) .

group without walls (GWW)

Business composed of physicians or medical practices into one management arrangement. Physicians see patients in their own offices but share administrative, billing, and purchasing expenditures. GWW contracts with managed care plans as a sole entity. Also called group practice without walls (GPWW) .

Grouper

Automated computer coding software program that classifies numeric diagnostic codes and assigns DRGs of discharged patients using the following information: patient’s age, sex, principal diagnosis, complications/comorbid conditions, principal procedure, and discharge status. A grouper is essential to reimbursement because it determines which type of complicated diagnosis and/or additional procedures affect a principal diagnosis and place the case into the appropriate DRG.