Search
 

Self-Funding: Stop Loss? Not Exactly

Strictly speaking, stop loss reinsurance is used by most self-insured employers to reduce exposure to loss with their health benefits.

By Bill Ford | Updated on March 01, 2015

Strictly speaking, stop loss reinsurance is used by most self-insured employers to reduce exposure to loss with their health benefits. The employer establishes a qualified plan document that becomes their group benefit plan. To this they attach a summary plan description that details the employee’s coverage, coinsurance, deductibles and co-pays.

The employer then hires a competent plan administrator to manage the administration of the plan benefits. The administrator also might provide a medical network that offers a discount on medical costs when incurred and they usually arrange a benefit prescription manager to mitigate cost of prescriptions.

Stop loss is often provided by the TPA to limit the employer’s exposure to loss or claim retention. There are two varieties of stop loss. One is the specific excess of loss and the other is an aggregate stop loss.

Complete your profile to continue reading and get FREE access to BenefitsPRO.com, part of your ALM digital membership.

Your access to unlimited BenefitsPRO.com content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events.
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com

Already have an account?

NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

Recommended Stories

BenefitsPRO

Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join BenefitsPRO.com now!

  • Unlimited access to BenefitsPRO.com - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
  • Exclusive discounts on BenefitsPRO.com and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2024 ALM Global, LLC. All Rights Reserved.