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Stop Loss
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Stop Loss Insurance

Protection for Self-Funded Employers

With more than 35 years in the Stop Loss insurance market, HM Insurance Group (HM) works to deliver smart solutions, exceptional performance and unparalleled support. Our Stop Loss coverage can be tailored to satisfy each client's level of risk tolerance, and you can trust that our underwriting experts are working to protect our policyholders’ financial well-being based on individual experience and group dynamics. With a wide range of deductibles and contract periods, our Stop Loss plans can be structured to meet specialized needs and mitigate potential claim risks.

Performance Distinction

As a leading Stop Loss carrier and direct writer, we work to optimize coverage through experienced risk management, excellent operational performance and successful cost containment practices. You can rely on quick, accurate payment of claims and an exceptionally high level of performance that enables you to focus on your own business goals. Talk with one of our experienced leaders to learn more about our approach to the market and build a relationship that lasts.

A Solid Contract

HM offers clients a Stop Loss policy that provides clarity, financial protection and choice. We know that the contract is the core of the carrier-client relationship and the foundation for mutual obligations. Our streamlined contract helps to ensure our policyholders know their coverage details. It’s written in language employers understand and offers choices for customized Stop Loss protection.

Claim Services from Dedicated Teams

Since we underwrite to pay claims, not to dispute them, you can count on responsive, timely administration of Stop Loss insurance claims. Our dedicated claims team uses streamlined processes to provide accurate and efficient reimbursement. Highlights include:

  • eClaims and low documentation submission options
  • Access to Centers of Excellence
  • Out-of-network discount negotiation services
  • Subrogation recovery
  • Collaboration on unusual/questionable services

Our Promise

We know that the heart of a smart business decision is the integrity of the transaction. Guided by knowledge and experience, we make sound, disciplined decisions to guard the financial health of our policyholders. When you work with HM, you can have confidence in the quality of what we are delivering.

Blog

Stop Loss Insights

  • Innovating for Next-Level Stop Loss Claims Processing

    You can probably imagine that working with more than 100 third party administrators (TPAs) means that HM Insurance Group (HM) receives tens of thousands of claim detail files every year. It’s a lot of data to manage. Files come into a secure, designated Stop Loss claims email box or via an FTP site. They are then saved to a corporate drive so our Claims team can format the TPAs’ Excel files into a format acceptable for loading into our claims system. The entire process takes a lot of manual work.  

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  • Coronavirus Considerations – Underwriting in a Changing Self-Funded Risk Landscape

    I have a confession to make. As I watched the Coronavirus pandemic spread throughout the world and into the United States in late January and February, I was openly derisive about the potential impacts. I was convinced this would just be another flu (don’t we have one of those already), and this would not likely be a significant concern, both from a risk/loss perspective and from a societal impact standpoint. It’s a good thing I learned an important lesson a long time ago: be humble in defeat. 

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  • Do Your Part to Recognize and Report Health Care Fraud

    Health care claims are more expensive than ever (many exceeding $1 million). In this industry, we frequently see the impact catastrophic claims could have, and it’s our job to help protect our clients’ financial stability should they face them. To make matters worse, some statistics I have heard in training seminars show that up to 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims.

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