One of the biggest concerns that employers have about implementing a self-funded insurance plan is unexpected high costs. Serious health events like surgeries, cancer, and COPD can cost a significant amount of money. This can deplete the funds available for your staff. However, there is an excellent solution that can balance against the high costs. Stop loss insurance is perfect for employers with self-funded health care plans. It can help balance against these high costs, while still allowing your business and your staff to benefit from a self-funded healthcare plan.
What Is Stop Loss Insurance?
Stop loss insurance is a type of insurance package that helps bolster against catastrophic claims. In the case of self-funded insurance, it helps provide resources to deal with unexpected, high healthcare costs. There are essentially two types of stop loss insurance that can be paired with a self-funded healthcare plan:
1. Aggregate Stop Loss:
Aggregate stop loss insurance places a cap on the amount of money a self-insured employer pays for the entire year. So if a major health event comes up that takes you over the allocated funds for your employer-sponsored health insurance, stop loss insurance will kick in. The cap is usually determined with a third-party administrator who can help determine the maximum potential liability for the self-insured plan. Then at the end of the year, any healthcare costs beyond the cap will be reimbursed by the insurance policy.
2. Specific Stop Loss:
Specific stop loss also sets a cap. However, the cap is per individual rather than the entire company. Then any amount over that cap will be reimbursed at the end of the policy period by the insurance plan. As with aggregate stop loss insurance, you will work with a third-party administrator to determine your cap for specific stop loss.
Both types of insurance use a deductible and which plan you choose depends on your business’ unique needs. In either case, they will help protect you against expensive claims that can deplete your healthcare funds.
How Do I Get Stop Loss Insurance?
When you work with a third-party administrator to develop your self-funded healthcare plan, they will also help you with your stop loss policy. They will assess a number of factors like your budget, the overall health of your staff, and the costs of medical care on the market. From there they will work with you to determine your coverage levels, deductibles, and caps. Then if you ever have to file a claim against your stop loss insurance, the third party administrator will also help you file the paperwork and manage your policy.
Stop loss insurance can help your organization manage unexpected and expensive healthcare costs. Paired with a self-funded plan, stop loss insurance can help you save a lot of money on employer-sponsored healthcare. To learn more about self-funded insurance and how stop loss insurance can help, Visit National Insurance Partners Inc.’s today or give us a call. We’ll help you find the best healthcare plan for your business.