An Interview with Nick Christos of Elite Underwriting

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Nick Christos of Elite Underwriting Service, a full service underwriting facility, sits down with the Medical Tourism Magazine to discuss the self-funded industry in terms of medical tourism and global healthcare.

Q: Please tell us about yourself and what Elite Underwriting does

Elite Underwriting Services is a full service underwriting facility.  We specialize in stop loss and limited medical insurance. We have approximately $150 million dollars in premiums; we are currently the largest privately held MGU in the country.  We are trying to complement our self-funded platform with additional products and services, including medical tourism and global healthcare.  We are a family-run business.  I started this company in the early 1990s with my Uncle, Russ Naylor.

Q: Elite is one of the most respected and largest managing general underwriter of reinsurance for Self Funded medical plans, can you tell us about this and the amount of insurance premium you write?

Currently, we manage approximately 150 million dollars of stop-loss premium with an additional 15 million dollars of limited medical premium.  Due to the market conditions and the nationalized healthcare agenda, we’re seeing a lot of upward and downward pressures on each of these products.  As a result of the dynamics, we are looking to add additional products or services, including individual voluntary limited medical and an exclusive arrangement with C.V. Starr for a short-term medical program.  Both of these products utilize a web-enabled click, quote and print technology platform.

Q: Can you tell us a little bit about your Self Funded business?

Our self-funded business really has been the backbone or the engine of our company’s success.  We originally started as a brokerage and consulting firm and we specialized in large groups that often had a self-funding component.  Mr. Naylor had a background in the TPA business in the early 1970s through the mid-80s. He had a third-party administrator, which specialized in paying claims for self-funded medical plans.


This propelled Elite into the self-funded market by allowing us to take the carrier and the underwriting authority out of the insurance company, thereby allowing us to collect premiums, paid claims, underwrite the risk, and write the book of business.  This has really allowed us to develop a large national presence with a great group of brokers, consultants and TPA’s that generate business for us and we partner with them to provide solutions to self-funded plans.  


To leverage our value proposition, we created a new position and Chris Walker is handling this position to more effectively negotiate the specific terms on accounts and more effectively manage client relationships.

Q: Tell us a little about the limited medical business that elite does.

Limited medical is an interesting product that Elite Elite developed to meet the ever-changing needs of the national healthcare market.  In 2003, we added a limited medical platform, that product has been a tough one to manage as a secondary product due to the Healthcare Reform impact.  However, we feel as though we’ve found an interesting niche in that marketplace and we’re hoping to be able to focus on new opportunities in medical tourism and global healthcare that we weren’t previously focused on.  


These changes have opened our eyes to different types of producers as well, through the MTA and the 3rd Annual World Medical Tourism and Global Healthcare Conference,  Sustainable Healthcare and Hospital Development Conference, Expatriate, Travel Insurance & Global Healthcare Conference and Self-Funded Conference in Los Angeles this September.  We’re looking at these as unique opportunities to meet and greet the top producers in these areas and we’re very excited to be attending.

Q: Why is medical tourism a great fit for a Self Funded medical plan or a Limited medical plan?

The reason for both of these to exist is because the plan sponsor or the business itself is looking for an alternative way of paying for health insurance premiums and they’re also looking to develop a plan that’s exclusive to their members; they want a plan that’s going to work for their organization.  If a group or a company has employees traveling outside of the US, or to Canada, Mexico, the Bahamas, etc, this is another way to expand their footprint for their network, but it’s also a nice incentive plan as well.  


There are a lot of executive health programs that are being offered at different hospitals or universities around the country.  I think the programs medical tourism promotes helps companies achieve their goals of offering lower cost, equal superior quality.   Through organizations such as Surgical Trip in Boca Raton, FL, an alternative delivery system with many positive outcomes can be offered.

Q: Do you think Healthcare Reform will increase health insurance costs and make Self Funded plans more attractive?

Absolutely,  and I also think that Healthcare Reform and any type of pressure from government for a nationalized healthcare plan is going to inspire physicians, health systems and hospitals to look at alternative ways of delivering their medical product.  It is not just the self-funded healthcare plans that are going to be affected, and it’s not just limited medical.  It’s a more global issue.

Q: Do you think Healthcare Reform is going to be really positive for medical tourism?

Again, absolutely, and I think that those that develop a niche in this marketplace and also a roadmap to delivering this opportunity to their clients, whether they are brokers, consultants, TPA’s, or large self-funded companies.

As an example, through our retail company, The Elite Group was hoping to have Jonathan Edelheit speak at one of our co-sponsored events with one of the Orthopedic physician groups that are inquiring about this.  Now, this group is a 300 or 400 employee company is not a self-funded and offers no limited medical, but the doctors make up a large portion of the plan and are definitely feeling a lot of frustration with the healthcare system and with the compensation they’re receiving as providers on that plan as well.  


Everybody is asking about medical tourism and global healthcare and they want to know how it impacts them and how they can benefit from becoming an active participant in this emerging industry.  It is an exciting time to be involved in medical tourism.