With a partially self-funded plan, you pay the claims as they are incurred. Stop loss protection is purchased to limit your financial exposure. Stop loss insurance protects you by paying when any one individual or the entire group exceeds a predetermined amount.
With a partially self-funded plan, you pay the claims as they are incurred. Stop loss protection is purchased to limit your financial exposure. Stop loss insurance protects you by paying when any one individual or the entire group exceeds a predetermined amount.
Specific Stop Loss
Specific stop loss limits the claims exposure, per person, up to a level you choose. Claims exceeding this level are covered at 100% by the stop loss coverage.
Aggregate Stop Loss
Aggregate stop loss limits the claims exposure for your entire group. If total claims paid by your group reach this level, the stop loss coverage assumes 100% of eligible expenses for the remainder of the plan year. This Aggregate stop loss limit is pre-determined by an underwriter and is based on your choice of Specific stop loss level and plan benefit design.
