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Stop-Loss

Stop-loss or excess loss insurance is one of the most critical components of any self-funded benefits plan. MedCost has a seasoned staff of underwriting professionals who work with you to arrange for high-quality stop-loss insurance. And because MedCost administers benefits for almost 150,000 lives, we have strong relationships with preferred, respected stop-loss carriers and Managing General Underwriters (MGUs). Our stop-loss partners provide us with maximum discounts due to our integration of PPO networks, health management programs, and claims administration.

MedCost takes seriously our responsibility to help you evaluate carriers and MGUs to insure that you are receiving the benefits you deserve from strong, dependable organizations. We thoroughly evaluate each carrier and MGU based on highly selective criteria. In addition, MedCost conducts its own ongoing quality review of stop-loss partners’ performance, including their underwriting philosophies, average claims turnaround time, and the carrier’s/underwriter’s reputation in the market. This assures that the stop-loss insurance we recommend will consistently meet our clients’ needs and requirements.

Most employers with self-funded health insurance plans purchase stop-loss insurance (also called excess loss or reinsurance coverage) to protect themselves from high claims and limit their financial risk. There are two types of stop-loss insurance— specific and

Specific Stop-Loss (x)
Specific stop-loss protects an employer from expenses that exceed a deductible amount on each covered person. The deductible amount is determined by the employer’s risk tolerance and the number of expected employee claims.
aggregate
Aggregate Stop-Loss (x)
Aggregate stop-loss protects an employer against higher than expected claims. At the end of the contract year, if total claims exceed the predetermined maximum, the stop-loss insurance carrier reimburses the employer for the amount above the limit.
—which are usually purchased together.

 

 

We only partner with
stop-loss carriers
that have received an
A or A+ rating from A. M. Best Co., whose independent, third-party ratings are recognized worldwide as the benchmarkfor assessing insurers’ financial strength, stability, and operating performance.

 

 
 
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