| |
Enabling Connections
With Ease
|
MEDICAL STOP LOSS
Medical stop loss, also known as excess loss insurance, is a layer of coverage that provides insurance protection to employers who choose to self-fund their health benefit plans. Self-funding is an effective approach employers use to significantly reduce costs and maintain control over reserves without sacrificing coverage. In addition to avoiding the excessive overhead costs frequently associated with fully-insured plans, employers also receive some tax benefits from self-funding. However, self-funding can incur a risk from large catastrophic claims. Medical stop loss insurance is designed to protect employers from that risk.
Product Highlights
- Minimum size group of 50 lives or more
- Guaranteed "no laser" renewal
- Discounts for quality PPOs, UR, Large Case Management programs and quality plan documents
- Flexible medical stop loss contract
Specific Stop Loss Coverage
Our Specific Stop Loss Coverage provides protection against catastrophic claim accumulation above the specific deductibles. Specific deductibles available from $10,000 to $500,000.
- Standard maximum limit: $1,000,000; options of: $2,000,000, $5,000,000, $10,000,000*
- Full range of contract claims bases: 12/12, 12/15, 12/18, 12/24, 12/36, 14/12, 15/12, 24/12, PAID
Aggregate Stop Loss Coverage
Our vendors Aggregate Stop Loss Coverage provides protection in the event that total paid losses exceed the expected claims plus corridor during the policy period. Flexible attachment points; 125% standard. Lower/higher available.
- Claims Bases: 12/12, 12/15, 12/18, 15/12, 24/12, PAID
- Standard Maximum limit: $1,000,000; options of: $2,000,000, $5,000,000, $10,000,000*
- Monthly or annual aggregate premium payment available
Optional Features
- Specific split-funded premium arrangement
- Simultaneous funding on specific reimbursements
- Monthly aggregate advance reimbursement
- Terminal aggregate coverage
- Terminal specific liability benefit
- Medical conversion available
- Contract Advantage Plan (CAP)
- Early Lock Down
- 2 for 10
- Split-Funded Aggregate
Vendor Services
In addition to our vendor’s innovative stop loss insurance, our vendors offer the following value-added services:
- Extensive technical and medical staff resources on-site
- Claim re-pricing capabilities; access to several passive PPO re-pricing arrangements
- Utilization Review and Case Management oversight programs
- Direct access to decision making personnel in administration, claims and underwriting
|
|
