Stop Loss Insurance Features and Options
Whether covering groups of 50 or 5,000, HM Stop Loss enables self-funded employers to protect their assets from unexpected large or catastrophic claims, helping to protect their financial well-being as health care costs continue to rise. Using a wide range of deductibles and contract periods, we structure custom plans to help satisfy specialized needs and mitigate claim risks.
Stop Loss Features
When you choose HM, you’re working with a leading national Stop Loss carrier and direct writer that understands the market and delivers the right coverage to your clients. Product details include:
- Contract periods of 12/12, 12/15, 12/18, 12/24, 15/12, 18/12, 24/12
- Specific deductibles from $25,000 to $2,000,000
- Aggregate coverage maximum up to $2,000,000 per policy period
- Generally, no new lasers or increase to existing lasers at renewal
- No signed disclosure form required at renewal
You'll also experience a dedicated claims team that uses streamlined processes to accurately and efficiently pay claims.
Stop Loss Coverage Options
HM offers a variety of options that allow you to select the right coverage for your clients’ particular financial situations.
Specific and Aggregate Terminal Liability
Employers can extend Specific and/or Aggregate Stop Loss insurance for an additional three or six months following termination of the policy to help reduce the risk of uncovered claims when a Stop Loss policy ends.
Specific Advance Funding
In situations where extremely high-dollar claims occur, Specific Advance Funding enables group customers to pre-fund claim payments to assist with cash flow challenges. This option, which often is referred to as “coordinated reimbursement,” can be selected at the point of sale or at renewal.
Aggregating Specific Feature
With this option, Specific billed premium is reduced in exchange for the policyholder assuming liability for a set dollar amount (Aggregating Specific Loss Fund) of Specific claims in excess of the deductible. Claim reimbursement begins after the Aggregating Specific Loss Fund has been satisfied.
Bridge Renewal
This feature is available for Specific Stop Loss coverage only, helping to fill the gaps that may occur for groups when paid claims fall outside of their run-out period. When the group renews a 12/15 or 12/18 Specific Stop Loss contract, HM retroactively adjusts the expiring contract to a 12/24 contract. The group must renew to receive the Bridge feature.
Monthly Aggregate Accommodation
With this feature, claims that exceed the monthly Aggregate deductible during the contract period are reimbursed monthly – monthly aggregate factors determine the Aggregate deductible. This allows for partial payments to Aggregate coverage during the policy year versus waiting until the end of the policy year for claim reimbursement. There is then a year-end reconciliation.
Offer Risk Solutions
Our Stop Loss Insurance product helps limit how much self-funded group clients pay for health care claims.
