The Municipal Reinsurance Health Insurance Fund or the MRHIF is a Joint Insurance Fund formed pursuant to NJSA 40A:10-36 et-Seq. The MRHIF was established in 1999 when its four original member regional Health Insurance Funds “HIF”s determined that additional cost savings could be achieved by pooling together to provide excess reinsurance and jointly purchasing on other health related services.
The MRHIF provides both Specific and Aggregate reinsurance coverage above its member “HIF”s Self Insured Retentions “SIR” for Medical and Prescription Drugs. The Fund has also procured TPA services, provider networks, Prescription Benefit Manager, wellness programs, enrollments systems and other related services on a joint purchase bases.
In addition to its HIF members the MRHIF will consider membership for self-insured local units that have at least 750 covered lives such as larger municipalities, Board of Educations, Counties etc.
As of 2020 the Fund includes Six regional local member HIFs, that insure over 185 Municipalities and/or School Districts in New Jersey.
NORTH JERSEY FUND (Municipal)
MRHIF Reinsurance Program
Specific coverageReimburses the MRHIF member (local HIF) for claims from any one person per contract year that exceeds its self insured retention “SIR”
Aggregate coverage- AvailableReimburses the MRHIF member (local HIF) for eligible claims for the entire group that exceed a predetermined amount, typically 120% of expected claims.
Specific/Individual Reinsurance Coverage:
A shock loss may be defined as an abnormally large and unexpected claimCould be the result of severe accident or serious illness
Each local HIF is protected against the financial impact shock losses can cause over their selected Self Insured Retention “SIR” .