Stop-Loss Insurance

Not familiar with stop-loss insurance? Don’t worry.
Our underwriting team can guide you with stop-loss insurance education and training, and provide innovative stop-loss coverage solutions depending on your financial strength and risk tolerance. 

Stop-Loss Insurance

Not familiar with stop-loss insurance? Don’t worry. Our underwriting team can guide you with stop-loss insurance education and training, and provide innovative stop-loss coverage solutions depending on your financial strength and risk tolerance. 

What is Stop-Loss Insurance?

Stop-loss insurance enables employers to preserve the financial viability of a self-funded plan. A self-funded plan provides the employer the freedom to determine benefits offered, plan exclusions, eligibility status, and cost sharing amounts for the employee and the employer. Nevertheless, the employer needs financial protection from the impact of catastrophic claims.  Stop-loss is a critical component for organizations pursuing a self-funded option to prevent putting employers at a greater risk from unexpected large claims and/or on-going costly medical conditions.  Each business is different and presents different risks. The decision to purchase stop loss insurance is unique to each company.

What does Stop-Loss Insurance Include?

Specific Stop-Loss

Specific Stop-Loss insurance provides self-insured employers with financial protection from large claims that occur for any one covered individual.  If the employee’s or dependent’s covered medical claims exceed the specific deductible level, the stop-loss carrier will reimburse the employer for the covered claims that exceed the limit.  The stop-loss policy reimburses medical expenses in excess of the deductible that are covered by the employer’s self-funded medical plan.

Aggregate Stop-Loss

Aggregate Stop-Loss insurance provides financial protection when the total of all claims under the Specific deductible is higher than expected. At the end of the policy period, The carrier reimburses the employer for all eligible claims costs above the pre-determined Aggregate deductible level.  Typically, employers choose a policy that covers medical and prescription drug expenses. In addition, if the employer wants to add more coverage, some stop-loss carriers can also provide reimbursement for dental care, short-term disability, and vision.  

Stop-Loss Group Captive 

A stop-loss captive is an insurance entity formed and managed by like-minded employers looking to increase control of their employee health benefit programs to reduce overall cost.  With a group stop-loss captive, small employers gain negotiating power of a larger company by sharing a layer of risk resulting in more predictable claims experience. Additionally, the overall cost of the captive is stabilizing which facilitates providing healthcare insurance to employees on a long-term basis. As with traditional stop-loss, the shared layer of risk in a stop-loss captive is capped by an excess limit and an aggregate reinsurance.  Generally small employers with 50–250 employees are potentially a good fit for a captive solution. Choosing a captive solution can also be an effective way for a fully insured employer to transition to a stop-loss funding arrangement. 

What is Stop-Loss Insurance?

Stop-loss insurance enables employers to preserve the financial viability of a self-funded plan. A self-funded plan provides the employer the freedom to determine benefits offered, plan exclusions, eligibility status, and cost sharing amounts for the employee and the employer. Nevertheless, the employer needs financial protection from the impact of catastrophic claims.  Stop-loss is a critical component for organizations pursuing a self-funded option to prevent putting employers at a greater risk from unexpected large claims and/or on-going costly medical conditions.  Each business is different and presents different risks. The decision to purchase stop loss insurance is unique to each company.

What does Stop-Loss Insurance Include?

Specific Stop-Loss

Specific Stop-Loss insurance provides self-insured employers with financial protection from large claims that occur for any one covered individual.  If the employee’s or dependent’s covered medical claims exceed the specific deductible level, the stop-loss carrier will reimburse the employer for the covered claims that exceed the limit.  The stop-loss policy reimburses medical expenses in excess of the deductible that are covered by the employer’s self-funded medical plan.

Aggregate Stop-Loss

Aggregate Stop-Loss insurance provides financial protection when the total of all claims under the Specific deductible is higher than expected. At the end of the policy period, The carrier reimburses the employer for all eligible claims costs above the pre-determined Aggregate deductible level.  Typically, employers choose a policy that covers medical and prescription drug expenses. In addition, if the employer wants to add more coverage, some stop-loss carriers can also provide reimbursement for dental care, short-term disability, and vision.

Stop-Loss Group Captive

A stop-loss captive is an insurance entity formed and managed by like-minded employers looking to increase control of their employee health benefit programs to reduce overall cost.  With a group stop-loss captive, small employers gain negotiating power of a larger company by sharing a layer of risk resulting in more predictable claims experience. Additionally, the overall cost of the captive is stabilizing which facilitates providing healthcare insurance to employees on a long-term basis. As with traditional stop-loss, the shared layer of risk in a stop-loss captive is capped by an excess limit and an aggregate reinsurance.  Generally small employers with 50–250 employees are potentially a good fit for a captive solution. Choosing a captive solution can also be an effective way for a fully insured employer to transition to a stop-loss funding arrangement.

Why Work with Skyline Benefit?

Our underwriting team has many years of experience as a stop-loss carrier underwriter.  We understand you need a carrier that you can trust and not be surprised by additional fees. Our process starts with understanding your business needs and risk tolerance. We go out to the marketplace and get you the best solution possible for your business needs.

With our network of reputable stop-loss carriers and group captive partners, we directly negotiate and handle your stop loss placement. Because of our exceptional forecasting abilities and self-funding expertise, carriers trust our experience and opinion.

We work closely with our carriers and group captive managers throughout your plan. We analyze your claims development, large losses and overall loss trend. We work with our partners as a team to monitor your claims.

Our Stop-Loss Services

Our Stop-Loss Services

Stop-Loss Carrier Partners

Stop-Loss Carrier Partners

If you have questions about stop-loss insurance, we’d love to hear from you.

Contact Us

If you have questions about stop-loss insurance, we’d love to hear from you.

Contact Us