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Employer Stop Loss Insurance

HCP National is an expert Stop Loss Insurance provider, since 1994.

For many businesses and institutions, the most cost-effective method of delivering Employee Benefits is to self-fund a business insurance program.

To manage your organization’s self-insured insurance portfolio within acceptable risks against unexpected losses and catastrophic claims, your portfolio should contain a customized Employer Stop Loss insurance product.

By adding Employer Stop Loss insurance coverage, you can mitigate possible claim costs and reduce the cost of employee health benefits, without disrupting your cash flow.

Why work with HCP National?

HCP National Insurance Services, Inc. has been helping clients find affordable professional liability insurance for Employer Stop Loss coverage since 1994.

We are experts in customizing your company’s business insurance portfolio to protect against devastating employee healthcare claims.

Check out the reasons below for considering HCP National for your Employer Stop Loss insurance:

Expert Stop Loss Liability Insurance provider since 1994

Co-Insurance and Cost-Saving Flexible Deductibles

Alternative Approaches to Minimize Fixed Costs

Up to 50% Savings on Insurance Deductibles with Same Coverage

Pay the Same Insurance Premium for More Meaningful Coverage

Specific Stop Loss & Aggregate Stop Loss Insurance Coverage

We have Employer Stop Loss Insurance that advances funding when your business or institution has a claim, so you have no unexpected out-of-pocket expenses. HCP National can customize your insurance portfolio to provide risk retention limitations for a “Specific Claim” or your annualized “Aggregate Claims.” Managing specific risks in your self-funded group health plan is necessary for your business’ protection from a very large claim or from collective members’ claims during the year or for the period of time your self-insured healthcare program is active.

As the cost of healthcare services continues to rise, many employers are encouraging their workers to consider voluntary benefits healthcare insurance products. With no direct costs to the employer, voluntary employee-benefits plans give employees an opportunity to protect their financial future from medical expenses incurred from an unexpected injury or sudden illness. Likewise, you can help your employees protect their income stream with short-term or long-term disability insurance plans to fill the gap in lost wages if they become disabled and are unable to work while recovering from any mishap.

HCP National has placed over $1 billion in stop loss liability insurance coverage. 

To speak with a specialist now, fill out our contact form and we will get in touch with you right away.

Stop Loss Insurance FAQs

What is Stop Loss insurance?

Stop Loss Insurance is used by an employer to cap their risk for self-insuring their group medical insurance plan. The stop loss is a defined dollar amount or high deductible per employee or dependent. Once this amount is reached, the insurer will pay or reimburse the excess above the stop loss deductible to the risk-taking employer.

Hypothetical example: A Specific Stop Loss Deductible is $100K. An employee has a $500K claim, so the Stop Loss pays $400K. The stop loss has no limit.

How does Stop Loss insurance work?

It pays or reimburses the risk-taking employer, or others, all eligible amounts above the Stop Loss Deductible, which can be a Specific or Aggregate coverage, or both.

What is the difference between Stop Loss, Excess, and Reinsurance?

Stop Loss as the name implies is when the risk-taker stops losing money and the insurer pays the excess amount or the amount above the Aggregate or Specific Stop Loss deductible. Excess is the amount paid over the deductible.

If the risk-taker is an insurance company, then the Stop Loss is called Reinsurance, as you are reinsuring an insurer. If it is an employer, multiple employer welfare arrangement (MEWA), or a health care provider, then it is called Stop Loss. Within these groups, Stop Loss is called Employer Stop Loss (or ESL: the self-insured single employer), MEWA Stop Loss, and Provider Stop Loss (or PSL: for the Provider group that is in a risk agreement with a Payor).

Is Stop Loss required insurance for Self-Insured plans?

A single employer who has a Self-Insured medical plan is not required to have Stop Loss, but they should. An insurer, such as a HMO, may be required by law or contract to carry Reinsurance. A MEWA is required in most states to have Stop Loss. A Health Care Provider in a risk contract normally is required to maintain Stop Loss, per their payor agreements.

What are the most common or desirable Stop Loss policy terms?

To ensure the most desirable Stop Loss policy terms for your situation, you should have an actuary set your Specific and Aggregate Stop Loss at a proper level, and make sure the Stop Loss policy has no exclusions that conflict with your Plan document.

What is the difference between Specific and Aggregate Stop Loss insurance?

Specific refers to a specific individuals covered for claims that exceed a high deductible amount or Specific Stop Loss. Aggregate Stop Loss covers the total claims below the Specific Stop Loss for every participant on the plan. If a group has an expected spend over $10 million dollars for the 12-month policy period, the aggregate deductible typically is based is at 125% of that amount, so in this example the aggregate deductible would be $12.5 million.  If the total claims spent on the group, below the Specific Stop Loss, are greater than $12.5 million the aggregate coverage will reimburse or pay the excess amount. For example, total claims spent below the specific stop loss is $14 million and the Aggregate Stop Loss attachment is $12.5 million, then the Aggregate Stop Loss will pay/reimburse $1.5M.

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Since 1994 – HCP’s top priority is finding clients the best possible coverage and terms at the lowest possible cost. HCP is a certified diverse (MBE & WBENC) insurance brokerage.