Reduce Your Risk of High Dollar Payout Claims
Self-funded employers can often find themselves with high-dollar employee health claims from severe incidents or diseases requiring hospitalization. Stop-loss insurance, or reinsurance, absorbs the risk in these situations and lowers a self-funded company’s financial burden by paying out claims over a certain specific and aggregate deductible.
You and your reinsurance carrier will work together to determine the level of financial risk associated with your self-funded plan and establish coverage to mitigate that risk. In exchange for a monthly premium, the reinsurance carrier will reduce your financial exposure and help you to set predictable costs for your self-funded health plan.
Due to our excellent relationships with A-rated stop loss carriers, we help you obtain affordable reinsurance quotes from our trusted business partners.
- Competitive pricing backed by A-rated national carrier
- Stop-loss bidding
- Fast stop-loss claims processing and payments
- Competitive rates
- SSAE 18 SOC 1 Type II Compliant
If you have a high dollar claim, we make sure you’re protected.
We are experts in administering and managing your benefit plan and all eligibility claims. The claims department is dedicated to reviewing all requests accurately, in a timely manner. Our in-house claims processing and service center ensures that we have direct oversight to audit stop loss claims and thoroughly check for the accuracy of itemized charges.
SSAE 18 SOC 1 TYPE II compliance reports verify that our company is meeting the highest industry standards to offer you the best in quality service and performance.
We handle all sizes of employer groups, big or small. Some of our services include:
- Deductibles beginning at $25,000
- Generous maximum benefits, up to unlimited
- Flexible contracts
- Terminal liability options
We take all the necessary steps to manage, monitor, and audit claims.
Stop-loss reporting data includes:
- Standard Specific Report
- Standard Monthly Aggregate Report
- Eligibility Report
- YTD Claims Summary
- Paid Claims Analysis
- Claims by Coverage Code (Medical; Dental)
- Excess loss Report for Claims over 50% of the S/L Deductible
- Top Provider Report (Medical; Dental)
- Aggregate Summary
- Potential High Dollar
If you’re interested in learning more about our stop-loss insurance or risk management solutions, contact us today!