Stop-Loss Insurance

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WHAT IS STOP-LOSS INSURANCE?

Medical stop-loss is designed to help limit an employer’s liability on catastrophic or high-cost claims. The general assets set aside for the self-funded health plan are insured against unforeseen risks. Medical stop-loss insurance provides a ceiling against individual costly claims or higher-than-expected healthcare expenses across the employee population.

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Types of Stop Loss Insurance:

Specific Stop Loss

  • A specific pre-determined amount per individual.

  • The employer funds claims up to stop loss amount, then reinsurance pays any claims above that.

Aggregate Stop Loss

  • Pre-determined claim amount on the entire group.

  • Claims over the specific stop loss amount don’t track towards aggregate stop loss.

Downloadable: Free Stop-Loss Chart!

SELF-FUNDED PLANS

Self-insured health benefit plans offer greater flexibility and an opportunity for savings.

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FIGHTING PHARMACIDE

Specialty drugs represent a growing percentage of total drug spending. Pharmasense fights these escalating costs.

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HEALTHCARE UNCENSORED

We address questions that are going unasked or unanswered and discuss the trends and issues having the most impact on employee benefits.

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