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It’s a balancing act self-insured employers understand well. Stop loss coverage protects your organization when catastrophic claims arise. However, not all coverage is the same. Contract terms and conditions can vary significantly. The MMA Stop Loss Center of Excellence can help you get the most out of your stop loss contract terms.
24
%
of employers have had a stop loss claim over $1M. (2)
86
%
of employers will have a stop loss claim each year. (2)
$40M
is the largest known claim for stop loss. (1)
Data source:
1. FDA.gov Jan. 15, 2019 News Release
2. 2020 Sun Life Stop-loss Research Report: High-cost Claims and Injectable Drug Trends Analysis
By working with the MMA Stop Loss Center of Excellence, your company gains access to industry experts that can help you identify highly favorable stop loss terms and conditions.
Contract Negotiations
We handle vendor negotiations to deliver advantageous contractual terms at aggressive premium levels.
Full Claims Support
We offer full claims support including tracking potential high claimants, submission to the vendors using automated file feeds, and processing timely payments.
Deductible Modeling
We use the Claros Model to show optimal specific deductible levels using historic claims.
Limited Liability
We utilize quality review processes and procedures to help limit the liability associated with stop loss.
Relevant Benchmarking
We complete benchmarking at national, regional, industry, and employee-size level.
Market Leverage
We provide fact-based market leverage based on MMA’s entire book of business for both marketing and claims escalation.