Our Services
Specialty Expertise.
Every Discipline.
AE & Associates combines stop-loss underwriting, actuarial plan design, in-house clinical review, and regulatory compliance under one roof — giving Hawaii employers a depth of specialty expertise rarely found in a single agency.
Stop-Loss & Specialty Risk
Protect your self-funded plan from catastrophic claims.
Stop-loss insurance is the financial backstop that makes self-funding viable for employers. Without it, a single catastrophic claim can devastate a plan. AE & Associates structures specific and aggregate stop-loss coverage that matches your risk tolerance, workforce demographics, and budget.
What's Included
- Stop-loss portfolio underwriting
- Risk analysis and pricing development
- Reinsurance placement
- Program design and carrier strategy
Self-Funded Plan Design
Actuarially-sound plan structures that control cost.
A well-designed self-funded plan is more than a contract — it's a financial strategy. AE & Associates brings actuarial modeling, TPA expertise, and Hawaii market knowledge to every plan design engagement. We build plans that are competitive for your workforce and sustainable for your bottom line.
What's Included
- Actuarial pricing and risk management
- Healthcare and reinsurance analysis
Clinical Services
In-house clinical review that reduces waste and protects members.
Most insurance agencies don't employ registered nurses, pharmacists, or certified coders. Ours do. Our clinical team reviews utilization, audits claims accuracy, and identifies opportunities to reduce inappropriate spending — while ensuring members get the care they need.
What's Included
- Clinical review using data analytics and hospital alerts
- Pharmacy and R/X review
- Medical coding: ICD-10, CPT, HCPCS (ortho, podiatry, surgery)
- Medical claims processing, auditing, and cost-containment
Team Members
Cindy Sardinha
Clinical Reviewer, RN
Wendy Iwasaki
Pharmacist / R/X Reviewer, PharmD
Cheryl Wilson
Medical Coder, CPC
Gwen Suzuki-Oishi
Claim Reviewer
Compliance & Regulatory
HIPAA, ERISA, and ACA compliance — built in, not bolted on.
Self-funded employer health plans carry significant regulatory obligations. HIPAA Privacy and Security, ERISA fiduciary duties, ACA reporting requirements — non-compliance exposes employers to serious penalties. AE & Associates embeds compliance into plan design and administration from day one.
What's Included
- HIPAA compliance oversight
- ERISA oversight
- Health and Welfare Plan financial statement analysis
Ready to Protect Your
Hawaii Employer Group?
Schedule a no-obligation consultation with our team. We'll review your current plan, model out alternatives, and show you what a true specialty partner looks like.