Stop Loss Solutions

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.