Archived Insight | May 12, 2021

Medical Stop-Loss Insurance Checklist

Segal works with hundreds of group medical plans to help them get the medical stop-loss insurance that best meets their needs.

We compiled this stop-loss insurance checklist you can use to make sure you’re getting the right coverage for your plan.

Get the Checklist

Download Now

Highlights from the checklist

The checklist can assist you with:

Determining the adequacy of your current stop-loss coverage by reviewing your actual claims data
Setting up monthly high-cost claim reporting
Implementing third-party audit protocols for any known inpatient hospital or drug claim with $100,000 or more in submitted claims pending
Obtaining current plan coverage documents and amendments annually
Requesting bids every two to three years to make sure you’re getting the best possible deal on your stop-loss coverage

There are many other important points covered in the full checklist.

Questions about medical stop-loss insurance?

To discuss the adequacy and competitiveness of your plan’s medical stop-loss insurance, get in touch.

See more insights

Hispanic Male At A Doctors Appointment With A Black Female Doctor Checking Blood Pressure

Reasons to Consider an On-Site or Near-Site Clinic

On‑site and near‑site clinics can reduce costs, improve access and experience, and deliver ROI while strengthening health and wellness programs.

Health, Multiemployer Plans, Public Sector, Healthcare Industry, Higher Education, Architecture Engineering & Construction, Corporate, Healthcare Cost Management

Read Full Insight

Black Male And Caucasian Female Pharmacists Working At The Pharmacy

Rx Claims Audit Recovers Millions for Employer Coalition

An employer coalition revealed pharmacy benefit manager (PBM) pricing errors through an independent pharmacy claims audit, recovering $5.5 million.

Pharmaceutical, Health, Benefits Administration, Benefit Audit Solutions

Read Full Insight

Asia Female Pharmacist Using Digital Tablet While Taking Inventory

New Requirements for PBM Reporting and Fee Disclosures

The Consolidated Appropriations Act of 2026 makes significant reforms to pharmacy benefit manager practices. See the impact on health plan sponsors.

Compliance, Health, Multiemployer Plans, Public Sector, Healthcare Industry, Higher Education, Architecture Engineering & Construction, Corporate, Pharmaceutical

Read Full Insight

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.