What Is Stop Loss Coverage

Stop loss provisions are a protection mechanism that have proven quite helpful to the insured individual. And 2) an aggregate attachment point that protects against claim frequency.

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Without this provision, the insured.

What is stop loss coverage. Employers can mitigate risk by using stop loss insurance. Stop gap coverage covers the costs associated with lawsuits brought on by employees who fall ill or are injured on the job. A stop loss insurance policy usually contains two components:

If paid claims exceed 125%, the stop loss carrier reimburses the amount above the maximum liability. While workers’ compensation insurance covers lost wages and medical expenses due to employee injury, stop gap coverage protects employers if the injured employee sues for additional damages beyond what is already covered. The policy’s specific coverage provides protection in the case of a singlecovered

Unlike conventional employee benefit insurance, stop loss insurance insures only the employer. As employee medical bills can quickly add up, being able to predictably cap expenses is critical. 1) a specific “attachment point” (or retention level”)“ that protects against claim severity;

Even with the affordable care act in place, healthcare expenses have risen dramatically in recent years. This is protection against abnormal severity of a single claim rather than abnormal frequency of claims in total. Individual stop loss coverage is often combined with “aggregate” stop loss coverage (see the explanation of aggregate stop loss below).

Stop loss insurance, also known as excess insurance, is a product that provides companies protection against unpredictable or catastrophic losses. Stop loss helps to protect the employer from the financial loss associated with catastrophic claims or a multitude of unanticipated claims as well as high costs associated with unknown medical claim risks and the rising costs associated with can cer, preterm birth, transplants, etc. Maximum liability is determined by projecting expected claims plus a margin (typically 25%).

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