Reports and Surveys | June 25, 2019
Stop-loss insurance provides protection against catastrophic or unpredictable losses.
It’s a common feature of many benefit plans and, with the burden of high-dollar medical claims continuing to increase in frequency and severity, it’s important to review how stop-loss coverage protects assets and makes costs more predictable.
Our infographic will help you understand how plans are using stop-loss insurance, including:
Here are some of the key findings.
Segal can review your actual claims data to assess the adequacy of your current stop-loss coverage.
If you have a relatively low deductible for your group size, consider raising it in order to lower your premium costs.
To assess the competitiveness of your coverage, we will draw on our database to compare your stop-loss coverage to the coverage purchased by similar plans.
You can define the criteria for that comparison by:
We can also help you renegotiate your stop-loss coverage. During that process we can explore relatively new options, such as prescription drug-only stop-loss coverage and shared-savings policies that pay experience-rated dividends if premiums exceed claim reimbursements by a pre-defined ratio.
Another option to consider is an aggregating specific deductible, an additional “bucket” that must be filled from any large claims that exceed the specific stop-loss deductible.
In exchange for assuming additional risk, the plan should receive premium savings. If reimbursed claims are lower than anticipated, the plan retains the difference.
If you’d like to learn more, just get in touch.
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.
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