Medical Stop Loss
In today’s business climate, managers need benefit solutions as resourceful and cutting-edge as the organizations they run. Because each business is unique and requires its own set of insurance solutions, diversity in provided benefits plans is needed.
For many employers it may be far more beneficial to pursue self-funding as a benefits solution. A self-funded group health plan is one in which the employer eliminates obligations to a health plan provider by assuming the financial risk for providing health care benefits directly to its employees. While experienced, successful business managers are experts at mitigating risks, many will gladly take on the risk exposures if the probability is good for a high payout. Aggregate and Specific Stop Loss Programs are designed to shift much of the catastrophic exposure away from the plan. Our program allows for sharing of profit with the stop loss carriers for the years of positive results.
Program Advantages
- Every client is 100% credible for refunding
- Renewal with Rate Cap with “No New Laser” at renewal
- Claims are paid based on a “mirroring” of plan document
- 120 day rate lock on qualified accounts
- Premiums are calculated based on increased credibility level of each group’s experience, pooled with the accounts participating in the program
- Reduces reliance on Stop Loss carriers conservative manuals
- Rewards programs with positive claims experience
Refund Opportunities
- Lesser of 15% of Actual Net Stop Loss Premium or 50% of Surplus towards the target loss ratio of 75%
- Clean Case Bonus Refund = 2.5% of Actual Net Premium
Stop Loss Program Scenarios
