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Stop Loss Solutions

How do you manage the risk and cost of your benefit offerings while maintaining a strong employee benefit program?

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 Marsh McLennan Agency’s Stop Loss Advisory Practice can help you get the most out of your stop loss contract terms.



of employers have had a stop loss claim over $1M. (2)



of employers will have a stop loss claim each year. (2)


is the largest known claim for stop loss. (1)

Benefits of Stop Loss Solutions

Our Stop Loss Advisory Practice helps you consider all your options.

  • Decide when indexing your deductible may be appropriate to stay in line with market trends
  • Understand the value of contract differences beyond the standard no new laser with rate cap conversion
  • Help contain and manage high-cost claimants like new gene therapies with emerging solutions
  • Identify current policy gaps
  • Determine when plan design changes can increase your exposure
  • Figure out when a captive solution may be a good fit


Stop Loss Solutions Features

By working with the Marsh McLennan Agency Stop Loss Advisory Practice, 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 our entire book of business for both marketing and claims escalation.

Frequently Asked Questions

As an employer, you constantly seek a balance between providing the health plan coverage your employees need while managing the costs and impact on your bottom line.

Moving to a self-funded plan helps employers reduce their overall costs. It also provides more flexibility in their plan designs and insight into their claims data. With a self-funded plan, an employer assumes the financial risk of providing employee health care benefits.

Under a fully insured plan, the employer pays a fixed premium, and risk is transferred to an insurance carrier. Under a self-funded plan, the employer pays health administration and claims costs.  
Fully insured plans can increase yearly. A self-funded plan may help you reduce costs and give your company control over health care expenses.

With medical stop loss insurance, you can enjoy the flexibility of a self-funded plan while capping potential losses. Once the claims exceed the deductible, the stop loss insurance carrier bears the costs, which can provide stability and confidence knowing your risk is managed.

Traditional stop loss usually includes both specific and aggregate stop-loss coverage.

Specific stop-loss insurance will protect you from an individual high claimant. For example, if your specific deductible is $50,000, your organization will pay all the claims for that member up to $50,000, above which the specific stop loss kicks in. Aggregate stop-loss insurance will limit the claims expense in total for your entire group. You may also see this referred to as the attachment point.

You will have multiple options to consider, from which carrier to partner with, type of contract, and options to help manage your overall risk. Your Marsh McLennan Agency consultant can work with our MMA Stop Loss Risk Advisory Practice to help analyze your data and find the coverage to meet your risk tolerance and budget, maximizing your opportunity to save money.

Working with your Marsh McLennan Agency team to analyze available data and your demographics to identify your risk tolerance is a start. There are many ways employers can move toward self-funding, including level funding, captives, and minimum premium options, to name a few. We can help you understand these options, the advantages or risks, and projected costs or savings for you to consider.

Marsh McLennan Agency can help. Our Stop Loss Risk Advisory Practice helps you to determine the most appropriate policy terms and conditions.  

We’ll work to provide an analysis based on historical performance and predictive analytics. Our experience helps you evaluate a variety of factors, from what deductible makes the most sense to what carrier partner we recommend based on your risk. 

Coverage terms and conditions can vary significantly, and the last thing you want is to have risk transferred back to your firm. We can help you understand the stop loss market, the carrier financial strength, key policy provisions like exclusions, or cost containment solutions to control your overall spend.  

Want to learn more? Reach out to your Marsh McLennan Agency consultant today to find out how we help employers capture savings through self-funding with stop loss.

Meet a stop loss specialist.

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